'Different tone'

Tuesday, June 30, 2009

BALTIMORE--The HME industry breathed a sigh of relief in June when CMS officials said they had no plans to implement national competitive bidding until January 2011. But the agency still intends to open the bidding window this fall, industry stakeholders are quick to point out.

“We can’t be lulled into a false sense of security,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “Competitive bidding is very much alive and three-dimensional. So it’s imperative that we continue to educate members of Congress on the issues with competitive bidding and keep them apprised of the program’s progress.”

At a June 4 meeting, CMS officials told members of its Program Advisory and Oversight Committee (PAOC) that it plans to evaluate bids during late 2009 and spring of 2010, and announce contract winners in the summer of 2010. The agency then plans to spend the fall of 2010 educating beneficiaries, referral agents and providers.

The more relaxed timeline for competitive bidding, at least on the back end, speaks to the new administration’s desire to work with the industry more openly and collaboratively, stakeholders said.

“There’s clearly a different tone,” said Seth Johnson, vice president of government affairs for Pride Mobility Products, who along with Bachenheimer attended the PAOC meeting. “The previous administration wouldn’t even acknowledge that there were any problems or that things needed to be changed. This administration does. I believe there will be more of a back-and-forth.”

One of the top concerns brought up by PAOC members at the meeting: That bidders don’t necessarily have to have a presence in a competitive bidding area (CBA) or experience in a product category to submit and win a bid. Another concern: That the process CMS uses to determine how many providers are needed to meet demand in each CBA is flawed.

“Critical issues were raised with respect to quality and access, particularly as they relate to capacity,” said Walt Gorski, a PAOC member and AAHomecare’s vice president of government affairs.

Gorski added: “We don’t know a lot about the underlying systems, so it has been hard to critique the process. We only know the outcomes of Round 1. Transparency will remain a challenge, but we remain cautiously optimistic on the whole process.”

Despite a different tone, CMS will likely go only so far in tweaking competitive bidding, stakeholders said. 

“To make major changes to competitive bidding, we’re going to have to get CMS to change the existing regulation on the books - that’s where Congress comes in,” Bachenheimer said. “Otherwise, we’re going to be able to make only minor tweaks.”