Medicare Compliance & Reimbursement

Seniors' access to care could suffer if DMEPOS suppliers are few

The feds remain mum about how many home medical equipment suppliers submitted bids in phase one of Medicare's competitive bidding program--but beneficiaries may be in for the biggest surprise.

Though the Centers for Medicare & Medicaid Services (CMS) was still projecting recently that nearly 16,000 suppliers would bid--and that more than 12,000 would be awarded contracts--the agency now says that only a few thousand suppliers of durable medical equipment, prosthetics, orthotics and suppliers (DMEPOS) may be in a position to sign on the dotted line for the new Medicare contracts.

In the 10 metropolitan areas included in the first phase of competitive bidding, only about 2,200 supplier "locations" are accredited, reported CMS' Sandra Bastinelli, speaking at the Oct. 11 meeting of the competitive bidding Program Advisory and Oversight Committee--the first public PAOC meeting on competitive bidding since the implementation of the bidding process.

And CMS isn't likely to find relief in the accreditation pipeline. Round-one bidders have until Oct. 31 to secure accreditation, but only about 100 more are expected to make that goal, Bastinelli said at the meeting.

That leaves many in the industry concerned about beneficiary access to products and services, says Seth Lundy, attorney with Fulbright & Jaworski in Washington, DC.

What CMS will do if the number of qualified bidders turns out to be an eighth--or less--of what the agency had expected remains to be seen. If there aren't enough winning suppliers, access to care will suffer, predicts VGM's John Gallagher.

Suppliers at the meeting continued to push CMS toward its goal of requiring accreditation for all DMEPOS suppliers, says attorney and PAOC member Asela Cuervo. "No one with criminal intent will go to the trouble of getting accredited," Cuervo says.

CMS officials, however, repeated their refrain that accreditation is essential only for suppliers participating in competitive bidding. "We have gotten word from some accrediting organizations that some suppliers [in competitive bidding's first 10 areas] have refused an unannounced survey," Bastinelli said at an Oct. 10 Home Health, Hospice and DME Open Door Forum. Suppliers who do so are "refusing to become accredited," for all intents and purposes, he continued.

The agency will unveil "in the near future" the next 70 competitive bidding areas in which DMEPOS competitive bidding will roll out, CMS announced. Bidding for round two will begin next year, and reimbursement based on that round is expected to start in 2009.