Competitive bidding: Congress puts pressure on CMS

Sunday, March 16, 2008

WASHINGTON - More than 100 U.S. representatives and senators have signed two "dear colleague" letters that demand CMS explain national competitive bidding's impact on small providers of home medical equipment.

The authors of the letters, Rep. Jason Altmire, D-Pa., and Sen. George Voinovich, R-Ohio, planned to send them to CMS Acting Administrator Kerry Weems today.

"It's a good showing," said Cara Bachenheimer, senior vice president of government relations for Elyria, Ohio-based Invacare. "These letters serve two purposes: They put pressure on CMS and they educate legislators whose constituents will be impacted, instead of them waking up one day and saying, 'Oh my god, what's happening in my backyard.'"

In the letters, Altmire and Voinovich state that Congress has no way to fully determine the impact of competitive bidding on small providers. As part of developing its final rule, CMS conducted an analysis of the program's expected impact, but it never shared the findings, other than to say, "the DMEPOS supplier industry is expected to be significantly impacted."

Stated Altmire: Despite a 30% small provider participation target and other "accommodations and assurances by CMS, we are not confident that the small business impact has been adequately reported by CMS."

The HME industry hopes the letters will force CMS to delay the first round of competitive bidding, set to kick off in July.

"Politically, this is about pressuring CMS to put the brakes on the program and take another look at things," said Michael Reinemer, AAHomecare's vice president of communications and policy.

Another "dear colleague" letter by Sens. Arlen Specter, R-Pa., and Robert Casey, D-Pa., is in the works, said Seth Johnson, vice president of government affairs for Exeter, Pa.-based Pride Mobility Products. The letter will cite two recent economic studies that question the effectiveness of competitive bidding, or at least how CMS envisions it.

"The letter will highlight the findings of the studies and call for a one-year delay in the implementation of the program," Johnson said. "That will give Congress adequate time to review, analyze and determine how they want to move forward with competitive bidding."