Medical supplies council monitors bid impact

Friday, May 24, 2013

ALEXANDRIA, Va. – Although AAHomecare’s Medical Supplies Council has a lot on its plate, it comes as no surprise that the impact of competitive bidding tops its agenda.

“We are looking into how Round 2 of competitive bidding is affecting Medicaid reimbursement rates,” said Peter Rankin, manager of government affairs for AAHomecare. “We’re also looking to see if there’s any push from private payers to get lower rates from DME.”

The council deals with issues affecting diabetes, ostomy, urological, incontinence and wound care supplies. 

One of the biggest concerns: diabetes testing supplies. The category saw an average cut of 72% in the national mail-order competition. That will be compounded by the “fiscal cliff” deal, passed in January, which included a provision that applies Round 2 mail-order payment amounts for diabetes testing supplies to supplies obtained at retail locations. That’s going to create huge access issues in rural areas, says Rankin.

“If you are in the middle of Montana and can’t get your supplies, how is that going to affect readmission rates and patient outcomes?” he said. 

Patient outcomes are also a concern when it comes to CPAP patients, says Rankin. CMS in June published a notice that states for items needing periodic replacement, like CPAP supplies, providers must determine whether the items are non-functioning before they replace them.

The committee is pulling together data to share with CMS that will show that the policy change could harm patient care.

“There’s a correlation between adherence and good equipment,” he said. “I think the regulation has been in effect long enough that we should be able to see sort of how the correlation happens.”