Round 2021: Providers vent, ponder next moves

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Friday, November 20, 2020

YARMOUTH, Maine – Industry reactions to CMS’s plans not to move forward with the bulk of the competitive bidding program were a mixed bag, but a number of respondents to a recent HME Newspoll say they were disappointed that the agency plays by a “different set of rules.” 

In October, CMS announced that it had dropped 13 product categories from Round 2021 because they did not achieve “expected savings.” 

“It did not impact us too much, except we were upset that CMS plays by a different set of rules when the bid would probably have paid out better for the suppliers,” wrote one respondent. “How does this work? They want their cake and eat it, too? Meanwhile, we as suppliers are struggling to keep up with cost when setting up Medicare patients.” 

Round 2021 was the first round of bidding under a modified program that included lead-item pricing and other changes to make the process fairer. 

For providers who had hoped to see a return to more sustainable reimbursement rates, it was a major blow.  

“I had really hoped that this would be the round where we would see rates increase, which would have had a ripple effect across other payers, so many of which have rates tied to Medicare,” wrote one respondent.  

Looking forward, respondents were evenly split on whether the announcement would have an impact on their strategic plans for 2021. With bid contracts off the table, some are deciding whether they want to stay in the Medicare business. 

“We had categories that we were planning on exiting in competitive bid areas, if we did not receive bids,” wrote one respondent. “Now we are reassessing what we are going to do in those categories. It also solidifies our shift away from competitive bid areas and toward rural areas.” 

At the end of the day, it’s access to HME that will continue to suffer, say respondents. 

“All the money spent on this program, all they did was limit access for beneficiaries,” wrote one respondent. “The issue now is the allowable for the 13 categories remains at the lower-than-cost amounts that the national companies bid, so there is still not going to be sufficient access to needed equipment and services. We field calls all the time with beneficiaries at their wit’s end.”