Providers must shift strategy for re-compete

Friday, August 24, 2012

YARMOUTH, Maine – If there's one thing HME providers who survived Round 1 of competitive bidding are sure of it's this: Things are about to get ugly.

Until now, if providers didn't win a bid, they could focus their efforts on products not included in the bidding program, but with a total of about 300 codes in the Round 1 re-compete, there aren’t a lot of safe harbors left. 

"If you don't win a bid now, you are in serious trouble," said Frank Trammell, president of Carolinas Home Medical Equipment in Matthews, N.C.

Registration for the Round 1 re-compete began Aug. 30. CMS will open the bid window Oct. 15.

Adding insult to injury: In the Round 1 re-compete, codes are organized into six larger product categories. That means, for example, that the general HME category includes everything from hospital beds and support surfaces to TENS devices and urinals.

"I think we all have to question the wisdom of such category groupings," said Gerald Sloan, owner and president of Progressive Medical Equipment in Lenexa, Kan. "What we've seen in Kansas City is picking and choosing of what products winners have chosen to do and not do. Grouping these into larger categories could make it much more difficult for people to get what they need."

Other categories, like the respiratory equipment category, which includes both oxygen and CPAP, make more sense, say providers.

"If I won just oxygen but I pick up a patient that has oxygen and a CPAP, they are not going to get oxygen from me and CPAP from someone else," said Fino Randazzo, owner of Florida Home Health in Orlando, Fla.

As for the bids submitted for the Round 1 re-compete, many providers say they will probably be within a few dollars of the Round 1 single payment amounts.

"I don't see how anybody could possibly go any lower than what they are right now," said Tim Bates, president of Premier Home Health Care in Orlando, Fla. "There might be room with some categories, but for most, I don't see how."