Next in line for competitive bidding: Vents and manual wheelchairs?

Thursday, April 21, 2011

BALTIMORE – Because CMS thinks Round 1 is going so well, industry stakeholders wouldn’t be surprised if the agency expands more than the number of competitive bidding areas in Round 2.

“The fear is that they see such incredible success that they’ll take the product categories in Round 1 and add to them in Round 2,” said Cara Bachenheimer, senior vice president of government relations for Invacare.

Earlier this month, CMS officials shared with members of the Program Advisory and Oversight Committee (PAOC) a list of the 20 product categories under consideration for Round 2. The list contains the nine product categories in Round 1 plus infusion pumps and related drugs; manual wheelchairs; off-the-shelf orthotics; negative pressure wound therapy devices; nebulizers; ventilators, TENS devices; commode chairs; patient lifts and seat lifts; blood glucose monitors; and lymphedema pumps.

The product category on the list that’s particularly worrisome to industry stakeholders: ventilators.

“I don’t know how you would competitively bid vents, because it’s such a clinically and service intensive product,” said Wayne Grau, vice president of supplier relations and government affairs for The MED Group.

A product category that industry stakeholders are fairly certain CMS will try to slip into Round 2: manual wheelchairs.

“CMS plans to improve coding for manual wheelchairs, but they put that on hold, so that’s a pretty good indication that they’ll be in,” Bachenheimer said. “The question is whether they will exclude some of the higher-end chairs. The expenditures there aren’t significant, so CMS may be receptive to excluding those.”

Industry stakeholders were able to get complex power wheelchairs (Group 3) excluded from Round 1, but it took an act of Congress.

A product category that raised eyebrows: patient lifts and seat lifts. Providers often consider these products cash items.

Unfortunately, at the end of the day, money, not quality of care, will drive CMS’s decision, industry stakeholders say.

“CMS is charged with targeting the product categories with the highest price tag or those where the beneficiary co-pay is the most,” said Walt Gorski, vice president of government affairs for AAHomecare.