Senators push 15-month delay for upcoming bid cuts

Thursday, March 17, 2016

WASHINGTON – Just days after CMS released new payment amounts for the latest round of its competitive bidding program, two senators have introduced a bill that would delay a second round of cuts planned for non-bid areas on July 1, 2016.

Sens. John Thune, R-S.D., and Heidi Heitkamp, D-N.C., introduced S. 2736 to delay the cuts 15 months to Oct. 1, 2017. A first round of cuts went into effect in non-bid areas on Jan. 1.

CMS earlier this week released the new payments amounts for the Round 2 re-compete. The agency will offer 12,181 contracts to 637 bidders. It plans to announce contract suppliers this spring, and go live with the new pricing and contract suppliers on July 1.

Other provisions of S. 2736, which already has 14 co-sponsors, include:

  • The ceiling for a bid submitted for applicable covered items may not be less than the fee schedule amount that would otherwise be determined for such items on Jan. 1, 2015;
  • In the case of items and services furnished on or after Jan. 1, 2019, the secretary shall solicit and take into account stakeholder input; and take into account the average travel distance and cost associated with furnishing items and services in the area, any barriers to access, the average delivery time, the average volume and the number of suppliers;
  • Not later than the first of each month, beginning with May 1, 2016, and ending with Sept. 1, 2017, the secretary shall publish on CMS’s website the results its monitoring of access of Medicare beneficiaries to DME and of health outcomes.

As a “pay for,” the bill advances plans to limit federal Medicaid reimbursement to states for DME to the Medicare payment rates from Jan. 1, 2019, to Oct. 1, 2018.

The senators co-sponsoring the bill are: Sens. Mike Crapo, R-Idaho; Jon Tester, D-Mont.; Pat Roberts, R-Kan.; Chuck Grassley, R-Iowa; Joe Manchin, D-W.Va.; Shelley Moore Capito, R-W.Va.; Mike Rounds, R-S.D.; Steve Daines, R-Mont.; John Barrasso, R-Wyo.; Thad Cochran, R-Miss.; Mazie Hirono, D-Hawaii; Michael Bennet, D-Colo.; Angus King, I-Maine; and Joni Ernst, R-Iowa.