Round 2019 remains a mystery

‘That it’s taking this long for them to make another announcement means there are changes being made’
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Friday, August 25, 2017

WASHINGTON – HME providers shouldn’t be worried that they’re closing in on one year before the launch of Round 2019 of competitive bidding and they don’t have any details on how CMS plans to proceed, stakeholders say.

CMS announced earlier this year that it would temporarily delay Round 2019 to give the new administration, including Tom Price, secretary of the U.S. Department of Health and Human Services, time to review the program. Since then, it has been radio silence.

“That it’s taking this long for them to make another announcement means there are changes being made,” said John Gallagher, vice president of government relations for The VGM Group. “I think the longer it takes, the better it’s going to be.”

CMS delayed Round 2019 on Feb. 7, just about a week after detailing its plans for the next round on Jan. 31. Those plans included a number of changes to the program, like adding a new product category for insulin pumps and supplies, implementing a lead-item bidding methodology, and introducing a bundled program for CPAP devices and supplies in five bid areas.

What changes are in play behind the scenes—the original changes and/or other changes that are in line with Price’s previous efforts to replace the competitive bidding program with a market-pricing program—are unknown, stakeholders say.

“We don’t know what direction they’re going in, or how far they’re going,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “But I don’t think anyone should be worried: Price is committed to making improvements to the program and anything that comes out will be better than what we have today.”

Stakeholders point out that Price has the authority to extend the existing contracts for Round 1 for another year and the existing contracts for Round 2 for another six months, buying CMS more time to tinker with competitive bidding.

“If I were a betting person, that’s what I’d bet is going to happen,” said Kim Brummett, vice president of regulatory affairs for AAHomecare. “That’s the logical thing to do.”

Stakeholders say that extra time will be necessary to make substantive changes to the competitive bidding program, a process that will require multiple levels of approval, including from the Office of Management and Budget.

“If they make the changes we want them to make, which are changes to the existing regulation, that’s a process with a capital P,” Bachenheimer said.