Home Health & Hospice Week

Things are getting back to normal for suppliers in former competitive bidding areas, but the fight over bidding isn't over.

Earlier this month the Medicare bill delaying competitive bidding for durable medical equipment 18 months and repealing the title transfer of oxygen equipment became law after Congress overrode a presidential veto (see Eli's HCW, Vol. XVII, No. 25, p. 194).

Suppliers applauded the delay to bidding. "We won," declared the Waterloo, IA-based VGM Group network on its Web site.

The delay will allow Medicare beneficiaries to "continue going to the medical equipment suppliers who they know and trust," praised Tammy Zelenko of Bridgeville, PA-based AdvaCare Home Services in a release from Rep. Jason Altmire (D-PA).

"We have won a significant victory for western Pennsylvania seniors, the doctors who provide their care, and home medical suppliers," Altmire added.

Suppliers also lauded the oxygen ownership switch. "Congress has taken the steps necessary to shield home oxygen patients and their families from the dangers of requiring vulnerable patients to take ownership of their equipment," cheered Peter Kelly of the Council for Quality Respiratory Care, an alliance of the nation's 11 big home oxygen therapy providers and manufacturers.

Accreditation change: Shortly after the bill became law, the Centers for Medicare & Medicaid Services issued preliminary instructions about the delay. All Medicare suppliers in bid areas were once again free to furnish all equipment.

In a July 18 email, CMS also cancelled the accreditation deadlines for the first two rounds of bidding. The agency originally called for round-one suppliers to gain accreditation by July 21 and round-two suppliers to do so by Jan. 14, 2009.

Still in effect: But all Medicare DME suppliers still must be accredited by Sept. 30, 2009, CMS reminds providers in the message.

Suppliers in bidding areas won't see an immediate return to cash flow, however. Medicare contractors will begin paying DME claims by July 28, it says in another July 18 message.

If claims were already denied or processed at lower rates due to bidding, contractors will reprocess them "to the extent possible," CMS says.

Watch out: However, don't expect contractors to fix all your claims without prodding from you. "In some instances suppliers will need to alert the contractor to claims that should be adjusted," CMS instructs.

Suppliers are generally pleased with the delay of the bidding program, but they aren't calling it quits on the topic now.

"While we won a decisive battle, the war is not over," VGM warns. "We must now fight to put an end to the competitive bidding program. The industry must continue with its grassroots efforts and maintain communication with their members of Congress."

The Bush administration seems to think suppliers have a good chance at overturning the program altogether. "The bill aborts a major money-saving reform for consumers and taxpayers -- by effectively killing [the bidding program]," said Health and Human Services Secretary Mike Leavitt in a Washington Times op-ed piece July 16.

"I can't explain why some members of Congress think that is a bad deal," Leavitt said of the program's projected $1 billion in savings. Leavitt didn't address the quality and access concerns raised by suppliers, patients, physicians and other industry advocates.

Watch for: CMS will issue contractor instructions and accompanying MLN Matters articles about the delay, DME MAC Palmetto GBA says in a Web site posting.

Note: More information is at http://www.cms.hhs.gov/DMEPOSCompetitiveBid.