Comments reflect lack of confidence

Friday, May 23, 2014

Editor’s note: AAHomecare reviewed the 185 public comments submitted in response to a CMS proposal to expand competitive bidding nationwide and found that the overwhelming majority of them were critical, with many citing ramifications in areas already experiencing bidding. What follows is a sampling of these comments.

Bad for business

“The Disability Rights Education & Defense Fund (DREDF) opposes any attempts to expand the competitive bidding program to include either additional regions or additional product categories,” wrote Susan Henderson, the group’s executive director. “We oppose any proposal to expand the program for the following reasons: 1) competitive bid pricing can drive smaller, community-based DME providers on whom people with disabilities rely, out of business, and 2) force DME providers to have smaller product inventories in stock, which has an impact on consumer choice, product quality and the speed with which urgent, emergency repairs can be made.”

Broken process

“Realistically, a full objective review should have been done between Round 1 and 2 before increasing the program ten-fold last year,” wrote Kamela Yuricich, executive director of the Ohio Association of Medical Equipment Services (OAMES). “The bidding process has been broken since its first round launched in 2007—from the initial problems of the website, to improperly disqualified providers, to the violation of CMS’s own bidding rules, such as the issuance of contracts to unlicensed providers. This has occurred through all four rounds in Ohio: Round 1, Round 1 Rebid, Round 2 and Round 1 Re-compete.”

Unfulfilled contracts

“Every day we receive new patients who have been searching the list of suppliers in their MSAs who have turned them away because they cannot supply the product,” wrote Cynthia Pazos, CEO of Diabetes Management & Supplies, a provider based in New Orleans.

Pazos gave a specific example regarding insulin pumps: When the pricing was announced, she was “concerned” about whether the product could be supplied at such a low price.

“However, I quickly recognized why it was so low,” she wrote.  “Many other suppliers contacted me to offer to give me their customers because they could not afford to supply the patients even though they accepted their bid offer. Most suppliers bid on a category in which they did not have their buying pattern established and knew nothing about.”

A better alternative

“CMS must make some fundamental changes to ensure a financially sustainable program,” wrote Nancy Payne, RN, M.A., director of organizational integrity & regulatory affairs for Allina Health Home Oxygen and Medical Equipment. “Market pricing uses an auction system to establish market-based prices around the country. These changes are consistent with Congress’ original intent: to create a program that is based on competition and market prices, while maintaining beneficiary access to quality items and services.”