HHS OIG to Study Medicare Beneficiary Access to DME

Study comes as long-awaited response to request made by House lawmakers in July.

It's said that patience is a virtue, and in the case of Rep. Tom Price (R-Ga.) and 138 other members of the House, a little virtue paid off. After receiving a request from Price and those lawmakers in July, the Department of Health and Human Services’ Office of the Inspector General has agreed to perform a study on Medicare beneficiary access to DME.

While the OIG hasn't yet detailed the parameters of its study, the July request was specific. The request asked the OIG to study CMS’s competitive bidding program and the National Mail Order Program for diabetic testing supplies to determine what impact those programs are having on access and quality of care for beneficiaries. The request emphasized the specific concern that evidence was showing programs were not adequately addressing manipulation occurring in the bidding process, a proliferation of non-compliance by contractors and inadequate transparency measures.

A letter from Price and the lawmakers requested that the OIG investigate three key concerns:

  • The process by which CMS develops the composite price from which the median price is derived for DMEPOS goods and services, as it directly impacts seniors’ access to products and services.
  • The current enforcement of contracted supplier organizations.
  • The health impact on beneficiaries.

“The concerns shared by a large bipartisan coalition in the House are that those goals are not being met by the current system,” Price said back in July. “That failure means the health and well-being of seniors is threatened and efforts to make Medicare a more responsive and innovative program are woefully underperforming. The bipartisan outpouring of support for this review of the competitive bidding program is a testament to the importance of this effort, the severity of the problems inherent in the status quo, and Congress’ commitment to addressing them.”

"We appreciate Dr. Price spearheading this effort and we feel confident that the access issues we have been talking about all along will be uncovered by this process," said Tom Ryan president and CEO of the American Association for Homecare. "AAHomecare will continue to work with Dr. Price, the OIG, and other members of Congress on this issue. "

About the Author

David Kopf is the Publisher and Executive Editor of HME Business and DME Pharmacy magazines. Follow him on Twitter at @postacutenews.

HME Business Podcast