Much Work to Be Done
Don’t be fooled by CMS’s Round Two delay.
- By David Kopf
- May 01, 2011
I think everyone in the HME industry breathed
a collective sigh of relief when CMS announced
at April’s Program Advisory and Oversight
Committee that it would delay the start date for
Round Two of its competitive bidding program
for DMEPOS by six months.
Not only have providers and patients been
reeling from the impact of the implementation
of Round One of competitive bidding, but given
the previous timetable, the industry would have
be bidding in no time flat. That’s a scary prospect
given how many providers have felt the sharp end
of Round One. To expand it into 91 additional
competitive bidding area that soon would have
been a frightening prospect indeed.
But don’t be lulled into a false sense of security.
You should still feel afraid — very afraid. Under the
revised timetable bidding registration will begin
this fall and ends in winter of 2012. That is not a
lot of time to get the program repealed. And that
has to be the industry’s and your primate objective.
Don’t wait for lawmakers to take notice. You must
educate them about the pending disaster.
Already, CMS has received 54,000 of what it
calls “inquiries” about the program since Round
One was implemented, but CMS is so out of touch
that it only labeled 43 of those “inquiries” as
actual, bona fide complaints (I’d love to see CMS’s
dictionary). Shocking, I know, but CMS seems
perpetually at odds with reality.
Nope, the Round Two delay is not an admission
on CMS’s part that its competitive bidding program
is having serious enough problems that they are
prompting patients and other constituents to gripe
in the thousands. Heck, CMS didn’t even acknowledge
the experts, so why should it pay attention to
what patients have to say?
Case in point: University of Maryland Economic
Prof. Peter Cramton assembled 166 economists
with expertise in auction models and had
them write a letter to Rep. Pete Stark (D-Calif.),
chairman of the House Subcommittee on Health
for the Committee on Ways and Means, and onto
CMS Administrator Donald Berwick. Cramton
then orchestrated a very compelling mock auction
using his own bidding system right before the
PAOC meeting. He even challenged CMS Director
Jonathan Blum to present just one single economist
that would say CMS’s bid system was the right
model for DME. But CMS is refusing to acknowledge
any those facts. Instead it is engaging in the
bureaucratic version of sticking its fingers in its
ears and yelling, “La-la-la, I can’t hear you!”
Which is why lawmakers remain your prime
target. At press time, H.R. 1041, the House bill
introduced by Representatives Glenn Thompson
(R-Pa.) and Jason Altmire (D-Pa.) that calls for
the repeal of the bid program, is at 83 lawmakers
supporting the legislation. Eighty-three might seem
like a lot, but given the window of opportunity
(as I mentioned, bidding begins in fall), the
industry does not have much time to build enough
momentum to get the bill to a vote. Moreover, the
industry still needs to identify a Senate champion
for a companion piece of legislation. Suffice it to
say there is much work to be done.
This means you must get on the phone and
reach out to your Representative and clearly outline
the benefit of homecare, why it makes financial
sense for taxpayers, and how beneficiaries — their
constituents — will be negatively impacted by the
program if it is not repealed. Let them know that
the program is only five months into implementation
and it has already generated tens of thousands
of calls to CMS. And don’t stop there. Mobilize
your patients and partners to do the same. Your
patients will be the most impactful at convincing
lawmakers NCB must be repealed.
Make no mistake, now is not the time to ease
back and take a breather. Round Two might have
been officially been delayed, but don’t let CMS fool
you; it will strive to implement this program no
matter how broken and harmful it is. Let your fight
be as relentless as CMS’s refusal to see reason.
This article originally appeared in the May 2011 issue of HME Business.
David Kopf is the Editor of HME Business.