Devil's in the details

 - 
07/23/2008

A few providers who have been pawing through H.R. 6331, the bill that delays national competitive bidding for 18 to 24 months, have called us with some interesting clarifications and discoveries.

One provider called us to clarify that some of the bidding improvements included in the bill don't apply to Round 1 of the program. The paperwork requirement (CMS must notify bidders about discrepancies and give them time to make corrections) applies to Round 1, but these improvements apply only to Round 2:

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*"The Secretary may subdivide metropolitan statistical areas with populations (based upon the most recent data from the Census Bureau) of at least 8,000,000 into separate areas for competitive acquisition purposes"; and
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*"The Secretary shall exempt from the competitive acquisition program (other than national mail order) the following: Rural areas and metropolitan statistical areas not selected under round 1 or round 2 with a population of less than 250,000."

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The provider emphasized the use of the word "may" and "shall." In other words, CMS doesn't HAVE TO subdivide CBAs or exempt rural areas.

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Another provider e-mailed us to share this discovery: The bill, in Section 154, states: "...the Secretary of Health and Human Services shall provide for the transfer from the Federal Supplementary Medical Insurance Trust Fund...to the Centers for Medicare & Medicaid Services Program Management Account of $20,000,000 for fiscal year 2008, and $25,000,000 for each of fiscal years 2009 through 2012.

That's $120 million in additional funds "for purposes of implementing the provisions of and amendments made by" the bill. The provider said: "That basically tells us Congress and CMS are $120 million more dedicated to the bidding process. That’s quite a bit of power that’s been handed to CMS without restriction."

Here's a link to H.R. 6331 (Just type in H.R. 6331 into "Search Bill Text.") What do you think?