Could bidding throw a wrench in the PMD demo?
You probably know Doug Westerdahl of Rochester, N.Y.-based Monroe Wheelchair. He’s extremely active in the complex rehab community and is a very sharp businessman. When I talk to him about the PMD demo, he’s got all these statistics and math and information—good stuff to have when you’re trying to run a company (or write a story.)
Since, as of Sept. 1, providers in the seven demo states will have been submitting prior authorizations for power mobility for one year, I reached out to Doug last week to ask how the demo was going for him. His answer: It’s not.
“We did not win any competitive bidding contracts,” he told me. “All of the PMDs that need prior authorization are in competitive bidding.”
Luckily for the patients, all of Monroe’s hard work getting documentation together to get a green light on their PMD follows the patient, so they won’t have to wait for another provider to go through all the steps. Unfortunately, that also means Westerdahl did all that work for nothing. It also means I’m out of a great demo source. (No worries, though: Those Medicare clients were only 3.9% of Monroe’s business, so Doug will still be around for me to harass on other topics in the future.)
Still, Doug did bring up an excellent point: A lot of providers (and CMS contractors) struggled in the beginning of the demo, just getting used to the new system.
Since Round 2 began July 1, providers who’ve never done power mobility before are now contract suppliers for PMDs, and some of those people are supplying in the demo states. Doug's question: Wonder how they’re doing with the demo?
I wrote to my source at CMS, and, the official had this to say:
Me: Are there new players in the PMD demo, now that Round 2 of competitive bidding is underway? How are those HME providers doing, compared to those who've taken part over the past year?
CMS: No changes were made to the demonstration as a result of competitive bidding Round 2.
Hm… I'm still wondering what throwing in a new test group and booting a bunch of providers will mean for CMS's demo experiment results. I’ll be keeping my eyes and ears open about this. Let me know if you hear anything.