Stakeholders stand ready to change bid program, with Price’s help

The broad underlying statute governing the program gives complete discretion to the administration, they point out
Monday, February 13, 2017

WASHINGTON – CMS’s decision to temporarily delay Round 2019 of competitive bidding could mean a revamp of the program, now that Rep. Tom Price, R-Ga., is taking the helm at the Department of Health and Human Services, say industry stakeholders.

CMS said on Feb. 7 it was delaying Round 2019 to give the new administration time to review the competitive bidding program. The announcement came one week after the agency announced it would consolidate all future rounds of competitive bidding into Round 2019.

“Given what we know of Price and his desire to make significant changes to the bidding program, I think this could be a good thing,” said Cara Bachenheimer, senior vice president of government relations for Invacare.

The Senate on Friday approved the nomination of Price, a long-time HME champion and the architect of an alternative to the competitive bidding program called market-pricing program.

Industry stakeholders have hailed the nomination of Price, but they acknowledge there’s no quick fix for the competitive bidding program.

“I think a lot of people think Price is going to come in and just do away with competitive bidding and that’s not the case,” said John Gallagher, vice president of government relations for The VGM Group. “He can’t scrap competitive bidding, but he can rewrite it to include the market-pricing program.”

In fact, the broad underlying statute governing the competitive bidding program gives complete discretion to the administration. Details like what products to include, what areas to include, and how to set the median bid are “all up for grabs,” Bachenheimer says.

“There could be a major revamping of the program,” she said.

CMS itself had outlined several changes to the competitive bidding program as part of Round 2109. Many of those changes are positive, like requiring $50,000 surety bonds for each CBA in which a bid is submitted, and moving the bid ceiling to the 2015 fee schedule.

As head of HHS, Price will have a full plate, but stakeholders say they stand ready to press him on the competitive bidding program.

“We have been working on our opportunities with Dr. Price as secretary since the beginning of 2017 and we are working on a strategy as we speak,” said Kim Brummett, vice president of government relations for AAHomecare. “He will have his hands full with the Affordable Care Act repeal and replace, but we hope to be able to work with him to make changes to the current program.”



That would be so Trumpian and ill-advised