Competitive Bidding:
DMERCs Could Hold The Reins On Bidding
Published on Fri Oct 15, 2004
Proposed bidding timeline revealed at first advisory committee meeting. The long-awaited Program Advisory and Oversight Committee meeting held some eye-openers for durable medical equipment suppliers in areas that took members by surprise.
One of the less welcome suggestions from competitive bidding contractor Research Triangle Institute was that the DME regional carriers could serve as bidding contractors. PAOC member Dave Kazynski, president of VGM's HOMELINK division, was surprised that the Centers for Medicare & Med-icaid Services is considering using the four DMERCs to implement DME competitive bidding, VGM says on its Web site.
PAOC members including Apria Healthcare Group Inc. CEO Larry Higby protested the DMERCs running bidding at the Oct. 6 meeting in Baltimore, according to press reports. DMERCs are already too overloaded to take on another huge burden, PAOC members said.
RTI did propose other methods of administration, including CMS running bidding in-house or a single outside contractor running the program, Invacare Corp. notes on its Web site. Invacare's Cara Bachen-heimer sits on the PAOC.
The impact of CMS choosing DMERCs or some other contractor isn't yet clear, says Erik Sokol of the Power Mobility Coalition. "It's the devil you know versus the devil you don't know," Sokol quips.
Another surprise was CMS' statement that it would pick "10 of the largest metropolitan statistical areas" for bidding implementation in 2007. Suppliers had thought that the top 10 largest MSAs would see bidding, but factors other than size now appear to be included in the consideration process.
Other issues discussed at the meeting included:
Timeline. CMS aims to issue a competitive bidding proposed rule this spring, with public comment and PAOC input following in the summer and fall, respectively. Spring 2006 is the target date for the final bidding rule, with implementation in 10 MSAs set for January 2007. Accreditation. The Medicare Modernization Act passed last December requires bidding suppliers to meet certain quality standards applied by "recognized independent accreditation organizations," RTI noted in the meeting. CMS has to decide how many accrediting bodies it wants to recognize, and which ones. On the list: Accreditation Commission for Health Care (ACHC), American Board for Certification in Orthotics and Prosthetics (ABC), Community Health Accreditation Program (CHAP), Compliance Team, and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Or CMS may want to administer the quality standards itself, RTI suggested. It could use the National Supplier Clearing-house as its accrediting body.
RTI also floated the idea of grandfathering in suppliers who are already accredited through "deemed status." When such suppliers' accreditation would lapse, they would be required to obtain accreditation through the new CMS-approved accrediting body. Bidding demonstrations. CMS presented summaries of its competitive bidding demonstration projects in Polk County, FL and San Antonio, TX. Medicare cut 18 percent [...]
