Contracts open up, but little changes

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Monday, April 1, 2019

EAST SANDWICH, Mass. – Since CMS let competitive bidding contracts expire on Dec. 31, 2018, Daina Juhansoo was hopeful that providers, previously locked out of the program, would be able to do Medicare business again. HME News recently spoke with Juhansoo, director of inpatient rehabilitation at Spaulding Rehabilitation Hospital Cape Cod, about how the competitive bidding program has impacted access and whether it’s improved in the new year.

HME News: What issues were you facing before the contracts expired?

Daina Juhansoo: Being on Cape Cod we have a good number of patients whose Medicare home zip code is 60 miles away or more from our facility. We obviously had to go through the process of identifying the vendors that we were allowed to use at time of discharge. Understandably, they often did not want to drive 60 miles to deliver a cane or a walker and so we wound up in a jam–often.

HME: Now that the lockout has ended, has it gotten better or worse? 

Juhansoo: It’s the same. We were foolishly excited that we would now be able to use our local vendors to get all of the needed DME. Knowing that the contracts expired, we called our closest vendors and were told they weren't able to supply the requested equipment because of the competitive bidding program. When we reminded them that it’s no longer in effect, they responded that they have not changed their practice. I understand that they're in a terrible situation and they're just trying to survive in an untenable position. It comes down to a very poor reimbursement, so unfortunately we're still functioning as if the competitive bidding program is still in effect.

HME: CMS says it plans to overhaul the program over the next two years. Are you hopeful?

Juhansoo: I suppose I should reserve judgment until they roll out their next attempt, but I can't imagine how they would have thought that this first program would have been successful. So I would say I am concerned.