Dozens of legislators demand competitive bidding delay

Sunday, July 15, 2007

WASHINGTON – A group of senators and representatives this week plans to send CMS two letters signed by dozens of their colleagues urging the agency to delay national competitive bidding.

Sens. Pat Roberts, R-Kan., and Kent Conrad, D-N.D., and Reps. Tom Allen, D-Maine, and Sam Johnson, R-Texas, crafted the sign-on letters, which ask CMS to address several issues before closing the bidding window and implementing the program. The Senate letter has about 10 co-signers and the House letter has about 30, according to Walt Gorski, vice president of government affairs for AAHomcare.

For the past few weeks, AAHomecare and other groups like the National Association for Support of Long Term Care have lobbied legislators to sign the letters.

The letters refer to “serious concerns that patient access to critical medical technologies and supplies will be severely restricted under the current implementation plans by CMS.”

In the letters, legislators urge CMS to address these issues:

• Outline how it plans to assess the program, especially its impact on clinical outcomes for patients.

• Delay the process until after all bidder conferences have been completed and as many providers as possible have begun and concluded the accreditation process. The letter states: “The 60-day bidding process does not provide sufficient time for suppliers to learn about the important details and obtain answers to key questions relevant to the preparation of their bids. Moreover, small suppliers that wish to participate in bidding networks must develop new business organizations, implement untried computer systems and address a large number of unresolved policy issues, including potential violations of antitrust laws.”

• Refine the proposed product categories. “Product codes used by CMS are too broad and inconsistent to adequately describe products with diverse ranges of quality, functionality, technology and clinical utility,” the letter states.

• Clarify the rights of winning providers to ensure that they’re not forced to provide an item at a loss. Under the median price methodology, half of the “winning” bidders will be paid for DME at a rate below what they bid. The final rule on competitive bidding doesn’t say whether those providers can withdraw from the program.

• Make distinctions between long-term care facilities, home health agencies and DME companies, which require different skills. The letter states: “DME companies are not equipped to service the needs of LTC facilities, which may serve 10 to 20 enteral patients. In addition, suppliers not currently serving the homecare market will have to make significant changes in the way they operate and service their customers, including carrying products with which they are unfamiliar. Patient care may be at risk as suppliers learn and adapt to new markets.”