Editor's Note

Much Work to Be Done

Don’t be fooled by CMS’s Round Two delay.

• By David Kopf
• May 01, 2011

I think everyone in the HME industry breathed a collective sigh of relief when CMS announced at April’s Program Advisory and Oversight Committee that it would delay the start date for Round Two of its competitive bidding program for DMEPOS by six months.

Not only have providers and patients been reeling from the impact of the implementation of Round One of competitive bidding, but given the previous timetable, the industry would have be bidding in no time flat. That’s a scary prospect given how many providers have felt the sharp end of Round One. To expand it into 91 additional competitive bidding area that soon would have been a frightening prospect indeed.

But don’t be lulled into a false sense of security. You should still feel afraid — very afraid. Under the revised timetable bidding registration will begin this fall and ends in winter of 2012. That is not a lot of time to get the program repealed. And that has to be the industry’s and your primate objective. Don’t wait for lawmakers to take notice. You must educate them about the pending disaster.

Already, CMS has received 54,000 of what it calls “inquiries” about the program since Round One was implemented, but CMS is so out of touch that it only labeled 43 of those “inquiries” as actual, bona fide complaints (I’d love to see CMS’s dictionary). Shocking, I know, but CMS seems perpetually at odds with reality.

Nope, the Round Two delay is not an admission on CMS’s part that its competitive bidding program is having serious enough problems that they are prompting patients and other constituents to gripe in the thousands. Heck, CMS didn’t even acknowledge the experts, so why should it pay attention to what patients have to say?

Case in point: University of Maryland Economic Prof. Peter Cramton assembled 166 economists with expertise in auction models and had them write a letter to Rep. Pete Stark (D-Calif.), chairman of the House Subcommittee on Health for the Committee on Ways and Means, and onto CMS Administrator Donald Berwick. Cramton then orchestrated a very compelling mock auction using his own bidding system right before the PAOC meeting. He even challenged CMS Director Jonathan Blum to present just one single economist that would say CMS’s bid system was the right model for DME. But CMS is refusing to acknowledge any those facts. Instead it is engaging in the bureaucratic version of sticking its fingers in its ears and yelling, “La-la-la, I can’t hear you!”

Which is why lawmakers remain your prime target. At press time, H.R. 1041, the House bill introduced by Representatives Glenn Thompson (R-Pa.) and Jason Altmire (D-Pa.) that calls for the repeal of the bid program, is at 83 lawmakers supporting the legislation. Eighty-three might seem like a lot, but given the window of opportunity (as I mentioned, bidding begins in fall), the industry does not have much time to build enough momentum to get the bill to a vote. Moreover, the industry still needs to identify a Senate champion for a companion piece of legislation. Suffice it to say there is much work to be done.

This means you must get on the phone and reach out to your Representative and clearly outline the benefit of homecare, why it makes financial sense for taxpayers, and how beneficiaries — their constituents — will be negatively impacted by the program if it is not repealed. Let them know that the program is only five months into implementation and it has already generated tens of thousands of calls to CMS. And don’t stop there. Mobilize your patients and partners to do the same. Your patients will be the most impactful at convincing lawmakers NCB must be repealed.

Make no mistake, now is not the time to ease back and take a breather. Round Two might have been officially been delayed, but don’t let CMS fool you; it will strive to implement this program no matter how broken and harmful it is. Let your fight be as relentless as CMS’s refusal to see reason.

This article originally appeared in the May 2011 issue of HME Business.