Time to Turn the Tide
Providers need to 'flip the script,' and reverse competitive bidding's pace.
- By David Kopf
- Dec 01, 2012
There are three things in this world that love
momentum: avalanches, floods and competitive
bidding. The Centers for Medicare
and Medicaid’s entire game plan for competitive
bidding seems based on the notion that as the
bid program advances, simple inertia will ensure
continued support for the program from Congress,
because no one will want to change a system that’s
If there is any doubt of that, just look at how
CMS has handled the entire debate:
- When it became clear from economists’ reports
that Round One of the program would shutter
HME providers, it debated the notion.
- When it became clear that program has shuttered
HME providers, it still debates that fact.
- When other reports showed that Round One
would diminish patient access to care, CMS
debated the argument.
- When records showed that Round One did
diminish patient access to care and resulted
in a cascade of complaints, CMS called the
complaints “inquiries” and debated the rest.
It even released a report (which most labeled
skewed) arguing no ill effect to make its case.
- When an army of economists including Nobel
Laureates told CMS its program was dangerously
flawed, it called their assessment — and thus
their expertise — into question.
- As providers and Medicare beneficiaries queasily
stand on the precipice of Round Two, CMS
continues to play up the notion that no harm
can come from competitive bidding, and that the
program is essential the fight against fraud.
The one thing that CMS has not done has
been to collaborate with the industry, and this
astonishes me. To my mind, when University of
Maryland Professor Peter Cramton, backed with a
legion of economists who were experts in auction
theory developed the market pricing program and
then staged a demonstration auction that worked,
CMS was handed a golden opportunity to collaborate
with the industry.
And I can’t stress the importance of that. I have
worked in a few heavily regulated industries before
I came to home medical equipment: telecommunications,
powersports (a fancy word for motorcycles,
scooters and ATVs), and finance. In each of those
cases, the industries and the bodies that regulated
them largely took a collaborative approach.
Am I going to say that, for instance, motorcycle
manufacturers were happy with every piece
of emissions regulation that the Environmental
Protection Agency handed down? Of course
not. But for the most part, the agencies and the
companies they governed sat down at the table
and hashed things out until a compromise was
struck. Heck, the Personal Communications
Spectrum auctions that were held by the Federal
Communications Commission in the 1990s were
considered a model for government auctions.
I’ve seen none of that with CMS. Instead, it
continues to brief lawmakers on the bid program’s
benefits (a specious case, in my book) and works
to shoot down anything and everything the HME
industry does to try and stop competitive bidding.
In short its activities are all about momentum.
Well now is the time to make some momentum
of our own. The industry has a golden opportunity:
Congress is in a lame duck session until Jan. 1, and
while it can’t forestall the fiscal cliff, it is desperate
to pass an agenda that minimizes its impact. The
“doc fix” to prevent cuts to physician Medicare
reimbursement is a key item on that agenda, and
H.R. 6490, the bill that would replace competitive
bidding with the market pricing program can easily
be attached to the doc fix if the bill gets enough
support. So, it is imperative that you contact your
Representative and continue following up during
this session until he or she co-sponsors the bill.
If you feel like you’ve been getting buried in a
competitive bidding landslide, here is your chance
to reverse the process and give CMS a taste of its
own medicine. Don’t miss out.
This article originally appeared in the December 2012 issue of HME Business.
David Kopf is the Publisher and Executive Editor of HME Business and DME Pharmacy magazines. Follow him on Twitter at @postacutenews.