Just say no?

 - 
04/23/2018

During a round of many calls last week, I spoke with someone who attended Medtrade Spring last month who spoke with someone else in-the-know about Medicare’s competitive bidding program. They discussed the question everyone wants answered: What. Will. Happen. Next?

Quick review: CMS on Jan. 31, 2017, announced its plans to consolidate all future rounds of competitive bidding into Round 2019, then on Feb. 7, 2017, the agency took it all back, saying it wanted to give the new administration the chance to review the program.

Since then, as the latter unnamed person above said, “It’s been crickets.”

One could argue that this won’t be the industry’s or the CBIC’s first rodeo with competitive bidding and, therefore, they don’t need the usual 16-month window to complete the process.

But as we stand today, April 23, it’s a little more than eight months from the conceived start date of Round 2019 on Jan. 1. Eight months, or exactly half the usual window.

And still crickets.

One has to think that CMS is feeling the weight of the current contracts for Round 1 2017, Round 2 re-compete and national mail-order program for diabetes supplies, which are all set to expire Dec. 31, 2018.

Industry stakeholders have suggested that CMS might extend the current contracts by, say, six months, to buy itself more time. Yes, this seems logical, and yes, this could end up being what happens.

But it may not be the fail-safe backup plan that CMS thinks it is.

I got an email from a provider earlier this month, asking a very good question: “I am a competitive bid winner for respiratory but am wondering if I have to extend my contract if I don’t want to?”

Currently, if a contract provider goes out of business or a contract provider is terminated, CMS offers the contract to the next provider in line. Presumably, that’s what they’d also try to do in the case above.

Still, it’s a great question, and if a good number of contract providers like the provider above refuse to re-up, the answer could get real messy real quick.