HHS budget proposes bid process for rural areas

Tuesday, February 13, 2018

WASHINGTON – The budget for the Department of Health and Human Services for fiscal year 2019 proposes two tweaks to Medicare’s competitive bidding program for DME.

First, HHS proposes eliminating the requirement that CMS pay a single payment amount based on the median bid amount and, instead, pay contract suppliers at their own bid amounts. Second, the agency proposes expanding the actual bidding process to all areas of the country, including rural areas.

“Expanding competitive bidding to rural areas will set prices for items and services in rural areas based on competitions in those areas rather than on competitions in urban areas,” the budget states.

HHS says in the event that less than two suppliers submit bids in a rural area, CMS will use a reference price from other, similar rural areas.

The agency says these changes will result in $6.5 billion in savings over 10 years.

The HHS budget also proposes eliminating what it calls the unnecessary requirement of a face-to-face provider visit for DME.

“Currently, physicians must document a beneficiary’s face-to-face encounter with a physician or non-physician practitioner as a condition for Medicare payment for a durable medical equipment order, which can be overly burdensome on providers and suppliers,” the budget states. “This proposal enables CMS not to impose this face-to-face requirement on all providers.”


So basically, budget office wants the big chains to prosper and to weed out the mom and pop stores.  I thought we were headed for relief with the IFR and H.R. 4229.   When will the madness ever end.

Obviously HHS and Mr. Azar are not on our side afterall as he is in favor of compettitive bidding in rural areas.  As was memtioned in htis article HHS is living in a fantasy world if they think there is any more meat on the bone to save 6.5 billion dollars. They have already cut us 51% and ther is nothing left to cut.  DME makes up what less than 3% of Medicare budget yet they continue to destroy access for people who have worked their entire lives only to have medicare fail them in thier time of need.  Oh, and as ABUTLER mentioned where is the relief with IFR and H.R. 4229. Let me answer that there is no relief as hard working providers continue to go out of business because medicare pays less than our costs! or they stretch payments out over 13 months causing major cash flow problems.  My vendors don't give me 13 months to pay my invoices.

In a word "REALLY"?!

Competitive biddng is ridiculous.  There is a more simpler way to save money and not put anyone out of business.  Medicare needs to do away with compitive bid, return the allowables back to a normal dollar amount and just reduce the percentage that they cover.  Change from 80% to 70%.  This would allow secondary plans to either increase their premiums and cover 30% or remain the same and the beneficiary would pay 10% out of pocket or 30% if they do not have a secondary insurance.  When is the government going to start using common sense?

. Let’s face it folks the big guys and girls at CMS are not stupid. They have seen what Sears and A & P did in the 1920’s then later what K-Mart, Wal-Mart, Lowes and Home Depot did to reduce prices and actually provide a better service to the consumer. Now it’s Amazon. By weeding out thousands of DME’s under 10 million (My Company included with $3 million in sales), our vendors will have less DME’s to deal with and they will be able to slash their overhead and accordingly lower their prices. With larger DME’s they will have audited financials and CMS will have less DME’S to deal with so they too can reduce staff. Oh yes, less fraud. Remember there are 3 things in life; death, taxes and CHANGE. 

I don’t mean to be such a pessimist and I hope I’m dead wrong.  Also, I understand the things us little guys do to serve the patient that the big guys don’t. I feel for the patients if my predictions come to fruition