Home Health & Hospice Week

Non-contract suppliers must furnish bidding notification to patients.

The durable medical equipment industry is keeping up the fight against competitive bidding, but the program seems to have momentum on its side.

The Centers for Medicare & Medicaid Services announced 325 contract suppliers for round one of competitive bidding, which will commence July 1 in 10 metro areas. Those suppliers received 1,345 contracts, CMS says. A list of the suppliers is at www.dmecompetitivebid.com/cs.

CMS chose the winning bidders from a pool of more than 1,000 suppliers who submitted nearly 6,200 bids. The bid prices will slash Medicare payment rates 26 percent below current rates, according to CMS.

The small business issue: CMS appears to be trying to head off some common criticisms of the program in its announcement. "Bids were evaluated to ensure there would be a sufficient number of suppliers, including small suppliers, to meet the needs of beneficiaries living in the [competitive bidding areas]," the agency notes in a release.

The monopoly issue: Suppliers not chosen for round one can subcontract with bid winners and re-bid for round two, CMS added.

Suppliers in the 10 round one CBAs aren't the only ones who should care about bidding, urges the American Association for Homecare. "This issue affects everyone in the home care community, whether you are in Round One, Round Two, or beyond," the trade group emphasizes in a message to members.

Why HHAs care: Even non-DME home care organizations need to care about bidding, adds the National Association for Home Care & Hos-pice. "This program may change the DME, prosthetic and orthotic suppliers that home health patients will need to use for their equipment," the association notes. And it "will prohibit home health agencies from providing DME to their patients unless they are awarded a competitive bid contract."

CMS has revamped its bidding web site, which has a new address at www.cms.hhs.gov/dmeposcompetitivebid. And it's issued a new chapter (36) to the Medicare Claims Processing Manual, which includes bidding policies and instructions, noted CMS' Joel Kaiser in the May 13 Open Door Forum for home care providers.

Medicare Obligations Continue For Non-Winners

Don't miss: Suppliers who didn't win bids and choose not to grandfather eligible bid items can't just wash their hands of Medicare business for those items, CMS says in the new manual addition. "Non-contract suppliers are responsible for providing notification to Medicare customers of their plans to either furnish grandfathered items or discontinue furnishing competitively bid item(s) that the beneficiary has been receiving from the supplier," AA-Homecare notes.

"Suppliers need to make these grandfathering decisions in the very near future and inform beneficiaries," Kaiser instructed in the forum that drew more than 600 participants.

Resources: The new chapter's first installment is at www.cms.hhs.gov/transmittals/downloads/R1502CP.pdf. Sample notification letters are at www.dmecompetitivebid.com --click on the May 12 "Important Grandfathering Instructions" link.

Lobbying, Lawsuit Seek To Delay Program

Meanwhile, the industry is pressing hard to secure a delay or elimination of competitive bidding. A recent House Ways & Means Health Subcommit-tee hearing that was critical of the program has given heart to suppliers (see Eli's HCW, Vol. XVII, No. 18). Observers expected another hearing scheduled for May 21 by the Committee on Small Business Subcommittee on Urban & Rural Entrepre-neurship to give suppliers' interests a boost.

And AAHomecare organized a May 21 fly-in to lobby lawmakers. Beneficiary advocates and other industry forces also planned a May 22 bidding briefing for benes and a patient-focused call-in to legislators.

Letters of support from groups such as the Consortium for Citizens with Disabilities continue to go to congressional leaders, AAHomecare notes.

Wider notice: The mainstream media is continuing to pay attention, too. An editorial in the Cleveland Plain Dealer called for a delay to the program, noting that beneficiaries are worried about access and availability issues. A CMS review should determine "whether streamlining to suit the government also serves patients well enough," the newspaper exhorts.

Legal challenge: A lawsuit filed in Ohio federal court is now asking the court to halt the bidding process. "The basis for the request is the failure of [CMS] to comply with ... public notice and comment provisions," says attorney Michael J. Jordan with Walter & Haverfield based in Cleveland. The suit filed last year is funded by Last Chance for Patient Choice and the VGM Group of Waterloo, IA.

What's next: CMS plans to hold another bidding education call on May 27 at 1 pm ET. "CMS Subject Matter Experts will be available to answer questions and address some of the exceptions and situations you may encounter as the program is implemented," the agency says of the 90-minute call. To attend, you must register for the call at www2.eventsvc.com/palmettogba/052908.

And DME Medicare Administrative Contractor and Competitive Bidding Implementation Contractor Palmetto GBA will hold an Ask-The-Contractor teleconference about bidding the same day at 10 am. You can use dial-in number 1-877-718-5095 and passcode 3848615.