GAO: More experience needed with DME bidding

Friday, May 11, 2012

WASHINGTON – The Government Accountability Office (GAO) says it's too soon to gauge the full effects of competitive bidding on Medicare beneficiaries and HME providers.

In its "Review of the First Year of CMS's Durable Medical Equipment Bidding Program's Round 1 Rebid," released May 9, the GAO found that, in general, the Round 1 rebid was successfully implemented, but notes that more experience with DME competitive bidding is needed to see if access problems emerge for beneficiaries.

"It was pretty cautious," said Cara Bachenheimer, senior vice president of government affairs for Invacare. "They are certainly not taking the position CMS is taking, which is, let's go forward with 91 more areas."

The GAO's review of Medicare claims data found that fewer beneficiaries received covered DME in CBAs during the first six months of competitive bidding, but said that does not necessarily mean that beneficiaries didn't have access to needed equipment. Instead, it could mean that competitive bidding reduced unnecessary utilization of DME.

"They said they are not seeing problems now, but they didn't draw any strong conclusions," said Seth Johnson, vice president of government affairs for Pride Mobility. "They are saying that more monitoring and oversight is needed as it goes forward."

Other highlights from the report:

• Relatively few contract suppliers had their contracts terminated by CMS, voluntarily canceled their contracts or were involved in ownership changes.

• Nearly identical numbers of suppliers submitted a similar number of bids for both Round 1 and the Round 1 rebid.

The Medicare Improvements for Patients and Providers Act (MIPPA) requires the GAO to examine certain aspects of the bidding program. The GAO analyzed data from CMS and interviewed CMS and CBP contractor officials, DME industry groups, and suppliers.