Competitive bidding: 'CMS has turned this industry into a nightmare'

Wednesday, December 29, 2010

WASHINGTON - HME providers are feeling a mixture of resignation, anxiety and anger now that competitive bidding is the law of the land.

"My emotional state right now is, let's get on with it," said Kim Brummett, vice president of contracting and reimbursement for Advanced Home Care, a contract supplier in the Charlotte competitive bidding area (CBA). "We did it before and it was awful, and most of us don't anticipate it will go well this time, either, but let's just get on with it."

Medicare implemented competitive bidding Jan. 1 in nine CBAs for nine product categories, despite a well-supported bill to repeal the program in the U.S. House of Representatives and other efforts by industry stakeholders and bidding experts.

Providers may want to "get on with it," but that doesn't necessarily mean they're all ready for it.

"We got a call from a contract supplier in Florida two weeks before the program started to see if we would subcontract for them for walkers--that's scary," Brummett said. "There's a little bit of a subcontracting frenzy going on."

But ready or not, with the program now live, the $64 million question is: How will it go?

"We're uneasy that we didn't get a bid, but we would have been uneasy if we did get a bid," said Terry Luft, president of ESMS Home Medical, a sub-contractor in the Pittsburgh CBA. "Your gut instinct is that you want a contract, but time will tell if you can survive at these rates and maintain access. There's got to be problems."

Providers that aren't in Round 1 of competitive bidding are equally interested in how the program and contract and non-contract suppliers fare.

"I'm watching attentively to see how the providers that did not bid or win bids make out, because I think I'm going to be in that boat," said Carl Mulberry, president of Columbus Medical Equipment in Columbus, Ohio, a Round 2 CBA. "I take pride in what I do, and I have no desire to become a Medicare-mill type of provider."

One provider who did not submit a bid in the Orlando CBA plans to rely on the loyalty and good sense of his customers.

"These folks know what I can provide and some of them will switch to cash (to stay with me)," said Steven Nelson, CEO and president of Okeechobee Discount Drugs. "They won't think it's worth it to go with a provider out of the county who won't provide quality service. They know what you pay for is what you get."

Whether providers are contract suppliers or not or in one of the CBAs or not, across the board, they still can't believe the sad state of affairs they're in.

"CMS, in their infinite wisdom, has turned this industry into a nightmare," Nelson said. "Without a doubt, providers are going to suffer and, more importantly, beneficiaries are going to suffer. This program rewards providers who are going to rip them off rather than those who play by the numbers."



Ditto for Liberty Medical and some of those CPAP mail orders too.

This is what happens when you put a lot of lawyers into a room and say "fix healthcare".