Problems, confusion reign during bidding’s first week

Sunday, July 6, 2008

WASHINGTON - Despite the HME industry's best efforts to derail it, competitive bidding kicked off on schedule July 1. Beneficiary confusion and some operational shortcomings at CMS kept providers and industry watchers busy during the program's first week.

Beneficiary confusion revolved around two main issues. Some beneficiaries not in the first 10 bidding areas somehow thought they must also participate in the bidding program. Additionally, some who use Medicare Advantage plans were told they must use a contract supplier. They don't.

"We are trying to assess how widespread this issue is, but we are hearing it from multiple sources," said Walt Gorksi, vice president of government affairs for AAHomecare. "CMS is putting the burden on the suppliers to educate beneficiaries or referring beneficiaries to Web-based systems, which we find curious."

The association is registering concerns and complaints. Providers can report their concerns at

Beneficiaries can do the same at

During a CMS conference call last week, CMS officials said they remain committed to a smooth transition.

"CMS will be monitoring this program closely to make sure beneficiaries are able to access products, services and suppliers, and we continue outreach with contract and non-contract suppliers," said Mary Worstell, director of CMS's Partner Relations Group Office of External Affairs.

In the days leading up to the program, the agency sent letters to 3.7 million affected beneficiaries and held outreach events across the country. That outreach is ongoing, said David Sayen, CMS's San Francisco regional administrator.

"There's a lot of work yet to be done," he said. "It's not a day one thing--it's the entire month of July."

A big concern among callers during the Q&A session was whether complex rehab contracts were awarded to enough clinically-qualified providers. One occupational therapist from the Dallas-Fort Worth area, said she was calling on behalf of all beneficiaries.

"Of 10 complex contracts (awarded), three winners were pharmacies, two of the winners do not do Medicare, one was up for sale, because he knows that having the bid increases his selling price, one was The Scooter Store, and one hadn't done rehab in over a year," the caller said.

CMS officials thanked her for her input.

Meanwhile, contract winners reported being busier than usual. Carol Muratore, COO of Richmond, Va.-based Home Care Delivered, a mail order provider, said her phones were ringing off the hook with calls from new customers and referral sources who had just learned they had to switch providers.

"Normally, we might have gotten two or three new referrals," she said. "That number has tripled."

Muratore said many of the new customers were referred from another contract winner unprepared to handle the contract.

"It's rough; the pricing is really aggressive," she said. "We have hired some people, but I am not comfortable extending (a lot of) job offers yet."