Licensure, capacity top questions for CMS officials

Sunday, November 8, 2009

BALTIMORE - During last week's Special Open Door Forum, CMS officials reiterated several key provisions providers should heed when preparing to submit bids under the national competitive bidding program.

The bidding window opened Oct. 21.

Covered document review

Suppliers that submit their hard copy financial documents by Nov. 21 will be notified of any missing documents, CMS officials said. This process determines only if there are any missing financial documents. It does not indicate if the documents are acceptable, accurate or meet applicable requirements. Suppliers will be notified of any missing documents within 45 days. Suppliers will then be required to submit the missing documents within 10 business days of notification.

"Please, please put your bidder number on every single page of every single document," said CMS official Martha Kuespert. "I can't stress enough the importance of (that). We need that number. It's the way we match your documentation to your bid."

Cindy Dreher, content and policy lead for the Competitive Bidding Implementation Contractor (CBIC), answered a host of questions submitted before the call, and also took questions from callers.


Q. "If we bid in multiple CBAs and somehow we inadvertently don't meet the licensure requirements in a given CBA, does that only disqualify us in that one CBA or does it affect the entire bid?" asked one caller.

Dreher's answer: It would only affect that location that is not licensed. You must have all the state licensure requirements before you bid. Make sure all required licenses are on file with the NSC. The licensure requirements depend on the specific state's regulation. You don't need to get licenses that are not required by the state.


Q. "How will capacity estimates be used to evaluate individual bids?" wrote in one provider.

Dreher's answer: Your capacity is the number of units that you can furnish per HCPCS code to a Medicare beneficiary in a calendar year. To determine your capacity, calculate the number of units that you currently furnish on a yearly basis then add any additional units you will be capable of providing annually at the start of the contract period. Your estimated capacity should be a realistic estimate of the number of units that you'd be capable of providing for one year, and you are expected to sustain this level of capacity for the entire contract period.

When we evaluate the capacity of a supplier that plans to expand its capacity, we will look at the expansion plan, as well as hard copy financial documents to determine if that bidder (can sustain that capacity). If your financial health and your expansion plan do not support your estimated capacity, then we'll adjust your estimated capacity to your historical level. Adjustments to the capacity have no effect on whether or not a supplier is awarded a contract.