Providers brace for delay aftershocks

Sunday, July 13, 2008

YARMOUTH, Maine - A probable delay in national competitive bidding (NCB) has been hailed as an industry victory, but it comes with some significant challenges for providers and beneficiaries.

Provider Rob Brant, for example, has kept his referral sources and patients up-to-date in an effort to prevent losing business.

"Once it's official, we will send out official notices," said Brant, president of City Medical Services in Miami, which was disqualified during the bidding process.

Meanwhile, Brant said, he has tried to conduct business as usual but admits there have been challenges.

"We've held off on our billing," he said. "Our software company has a new version with NCB areas broken down by zip codes with different prices."

For contract winners who have invested in staffing, inventory and advertising, a delay presents some major inconveniences.

"It was a stinking system to start with and it's worse now," said Edward Eubanks, owner of Charlotte Respiratory Solutions in the Charlotte competitive bidding area.

For the 3 million Medicare beneficiaries affected by Round 1 of NCB, a delay could mean further confusion and upheaval.

"We have taken enteral patients from several providers," said Randy Freeman, owner of Mediwell in Fort Worth, Texas, a contract winner in several categories. "I've told the providers that if the program does not go through, I would transfer the patients back. It's not fun and it could be the middle of next month before we do any billing."

However a revamped program gets shaped, providers would be wise to take advantage of an 18- to 24-month delay to improve their business model, say industry watchers.

"I am prepared to take a 9.5% cut," said Howard Rich, owner of Diabetes Care Network in Pompano Beach, Florida. "We've got to constantly get more efficient and hope manufacturers work with us. You adapt or go out of business."