Home Health & Hospice Week

If your patients aren't affected by competitive bidding for DMEPOS yet, they probably will be soon.

Round 1 of competitive bidding for durable medical equipment began in January in nine metro areas for nine product categories of bid items. Now the Centers for Medicare & Medicaid Services has launched Round 2, which will take effect in July 2013. In this round, bidding will spread to 91 metro areas nationwide and include new product categories -- negative pressure wound therapy pumps and nationwide mail-order diabetic testing supplies.

Although Round 2 adds some items, it actually has fewer categories because it combines manual wheelchairs, power wheelchairs, and scooters into one expanded category, CMS explains in a fact sheet about the program. Round 2 will not include Group 2 complex rehabilitative power wheelchairs while CMS evaluates the product's "suitability" for the program.

The other Round 2 items are oxygen, enteral nutrition, CPAPs and RADs, hospital beds, walkers, and support surfaces. That's a smaller group of bid items than many suppliers expected, notes the National Association of Independent Medical Equipment Suppliers.

After an education and registration period, the bidding process will begin in winter 2012 for 2013 implementation, CMS says.

"The success we've had in the first phase tells us that we can achieve these savings with no disruption for patients' access and no negative effect on patients' health," Deputy CMS Administrator Jonathan Blum says in a release.

Under Round 2, "we're taking steps that will save Medicare, seniors, and taxpayers $28 billion over 10 years," CMS Administration Donald Berwick says. "Medicare is paying much more than the private sector for equipment like wheelchairs and walkers."

CMS's assertions that the program does no harm isn't accurate, the American Association for Homecare contends. Under Round 1, more than 500 patients, clinicians, and home care providers have reported problems ranging from difficulty finding a local equipment or service provider to delays in obtaining medically required equipment and services to longer-than-necessary hospital stays due to trouble discharging patients to home care, the trade group reports.

And lumping manual and power wheelchairs together will exclude from bidding many small suppliers who furnish manual wheelchairs only, predicts NAIMES'Wayne Stanfield.

The program undermines the quality of care and actually increases costs, AAHomecare argues. "Because of this bidding program, beneficiaries will spend more time in expensive institutions, rather than in the far more cost-effective setting for care -- their own homes."

Remember: HHAs that furnish DME to their patients won't be able to do so under Round 2 bidding, if they are in a bid area and are furnishing bid category items.