CMS: Bidding Not Hurting Access to HME

Agency says data shows no outcomes changes due to bid expansion; AAHomecare urges providers to continue PADME push.

• By David Kopf
• Jun 08, 2016

Citing data it posted May 17, the Centers for Medicare and Medicaid Services released a statement yesterday that its competitive bidding program is ensuring access to equipment for DMEPOS patients in both bidding and non-bidding areas.

The health outcomes monitoring data are available at http://go.cms.gov/1U7EXY8.

CMS reported that it had monitored health outcomes in non-competitive bid areas subject to the national bid expansion, and had not detected “any changes in the number of deaths, hospital and nursing home admission rates, monthly hospital and nursing home days, physician visit rates, and emergency room visits in 2016 (after the new, adjusted DMEPOS payment rates were in place) compared to 2015.”

CMS went on to state that the amount of supplies impacted by the bid expansion had remained steady during the implementation, and that DMEPOS-related calls to 1-800-Medicare from those areas declined in the first quarter of 2016 compared to the number of calls received in the first quarter of 2015.

“This means that providers and suppliers are both accepting the new, adjusted payment rates and are still providing the same volume of these suppliers to beneficiaries,” the statement read.

The news comes at a time when the industry is engaged in a concerted lobbying and advocacy push to get lawmakers to support the Patient Access to Durable Medical Equipment (PADME) Act of 2016 before CMS implements the full funding cuts associated with national bid expansion on July 1.

“CMS’s assertion that the new cuts won’t negatively impact patients at this point is akin to declaring a baseball game over in the second inning,” said Tom Ryan, president and CEO of the American Association for Homecare, which is leading the lobbying effort. “Obviously, many providers in rural areas weren’t all going to stop serving their communities in the first few months after the first round of these cuts took effect, but there’s no doubt that these drastic reductions are going to start to have a negative impact — whether it’s from companies closing their doors, refusing assignment, or narrowing their offerings. 

“You need more than 120 days’ worth of data to really get a good idea where this is headed,” he continued. “This kind of narrow and mistaken extrapolation of data over a very short time frame is exactly why we need to pass legislation that would require CMS to provide a longer monitoring period before doubling down on a new set of cuts.”