AAHomecare, GAO Discuss Bidding Problems

Association brings laundry list of issues associated with the bid program.

Representatives from the American Association for Homecare met yesterday with the U.S. Government Accountability Office (GAO) to discuss problems associated with the competitive bidding bidding program for HME.

As mandated by the Medicare Modernization Act of 2003 (and modified by the Medicare Improvements for Patients and Providers Act of 2008), federal law requires GAO to conduct a study of the bidding program and issue a report, the association noted.

AAHomecare brought a number of agenda items it wanted to address at the GAO meeting including:

  • Lack of transparency in the program with respect to calculating provider capacity, financial requirements, and calculation of winning bid prices.
  • Flaws in the bidding methodology, such as calculation of payment amounts, median pricing methodology, composite bids and weighting of HCPCS codes, non-binding bids, “bona fide” bids, and capacity calculation.
  • The negative impact on Medicare beneficiaries, and specifically diminisehed access to specific brands or models, lower quality of products and services, delays in hospital discharge and delivery of equipment to patients’ homes, need of multiple providers, reduced ability to get power wheelchairs repaired, and the switch to retail outlets for diabetic supplies.
  • Negative impact on small HME providers, including business closures, reduced volume of business, grandfathering, subcontracting, and other challenges to the ability to continue serving seniors and people with disabilities.

Other issues for discussion included frustration that more input was not accepted from the Program Advisory and Oversight Committee on competitive bidding (PAOC); concerns about the burdens created by Form C; and the need for more bidding data to be public.



About the Author

David Kopf is the Editor of HME Business.

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Comments

Fri, Aug 19, 2011

To be blunt....They don't have a clue. This year marks my 24th year in the DME business and I never would have believed it would come to this. We have got to be the most regulated industry in the country. Multiple audits, accreditation, surety bonds, site visits, reimbursement cuts, enrollment revalidations, increased costs, extrapolations and on and on. Who would want to start a DME business now??

Fri, Aug 19, 2011 Spider

My small business is in the next round. Not being ready to go out of business every step that can be taken to enlighten CMS should be taken. CMS is obviously out of touch with the actual business of DME. Thanks for your efforts.

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