Bidding on the brain

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09/25/2018

Fall always makes me think of the end of the year, and the end of the year always makes me wonder about the most read stories of the year.

I just pulled that data for Jan. 1, 2018, through today, Sept. 25, 2018, which represents roughly three-quarters of the year, and the top 10 most read stories are listed below.

As you can see, the list is dominated by competitive bidding news, and it has been a roller coaster year for the program. We wrote about—and you read about in earnest—everything from HHS’s proposal to roll out a bid process for rural areas (not just bid-influenced pricing, but an actual bid process) to CMS’s proposal later in the year to pause the program while it makes substantive changes.

We knew that Seema Verma’s acknowledgement that there are flaws with said bid program—the first time a CMS official has acknowledged as much, stakeholders say—was going to attract a lot of hits. Thanks again to Theresa for staying past 5 p.m. to listen to the conference call and file this important story.

In the wake of CMS’s proposal to pause the program and implement an any-willing provider provision, a whole new set of questions cropped up and we sought answers in a number of follow-up stories, including “Any willing provider? It’s not a unanimous decision” and “Expect shifts to Medicare’s provider base, poll respondents say.”

Now that I’ve pulled this data, it makes me think of how it will change in the next three months. I can guarantee you that one story we haven’t written yet will knock one of these stories off the list: In November, stakeholders expect CMS to publish a final rule with final bid changes.

Stay tuned.

CMS upends competitive bidding
Agency pauses program with plans to implement significant changes, including some that stem from industry recommendations
WASHINGTON – All Medicare-enrolled HME providers are back in business starting Jan. 1, 2019.

CMS’s Seema Verma: Current bid structure ‘not sustainable’
WASHINGTON – CMS Administrator Seema Verma says she wants to “modernize” the agency’s long-standing competitive bidding program for DMEPOS by instituting market-oriented reforms.

Amazon wants to disrupt health care, including DME, report says
BOSTON – DME is one of five possible points of entry for Amazon to dominate the healthcare market, according to a new report from global management consulting firm L.E.K. Consulting.

Proposed rule: Current bid contracts won’t be extended
Rule also proposes adjustments to fee schedule methodology, establish separate payment class for oxygen
WASHINGTON – A proposed rule released today seeks to make changes to the Medicare fee schedule and the competitive bidding program.

Embattled Arriva Medical closes
CORAL SPRINGS and BOCA RATON, Fla. – Arriva Medical is closing its facility in Coral Springs and laying off 142 employees, the Sun Sentinel reports.

CMS adds templates for RADs, PAPs and vents
Of the three, RADs top the improper payment rate at 63%
WASHINGTON – CMS unveiled the first drafts of clinical templates for respiratory-related items at a Special Open Door Forum April 19.

Stakeholders ‘aghast’ at bid proposal
 ‘We’ve already stripped the benefit and I don’t think there’s any more savings to be had’
WASHINGTON – Industry stakeholders say they are as surprised as anyone by a proposal to expand Medicare’s competitive bidding program to rural areas.

CMS rule falls far short of bid relief
 ‘We have to go back to Congress and tell them, you have to fix it’
WASHINGTON – The long-anticipated interim final rule landed with a thud last week, when it became apparent that it offered little in the way of bid relief, say industry stakeholders.

Any willing provider? It’s not a unanimous decision
YARMOUTH, Maine – Reaction among providers to CMS’s any willing provider provision run the gamut—with some feeling disbelief, some contemplating new opportunities, and some discounting the idea outright.

Expect shifts to Medicare’s provider base, poll respondents say
60% of non-contract suppliers, 33% of contract suppliers say they’re out
YARMOUTH, Maine – The majority of non-contract suppliers who responded to a recent HME Newspoll (60%) say they won’t try to pick up Medicare business starting Jan. 1, 2019.