The Centers for Medicare & Medicaid Services has delayed the effective date for the interim final rule that would have restarted the process for round one of its competitive bidding program on Feb. 17.

The rule, entitled “Medicare Program; Changes to the Competitive Acquisition of Certain Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) by Certain Provisions of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA),” delays the effective to April 18 to “allow Department officials the opportunity for further review of the issues of law and policy raised by the rule,” a CMS statement says.

The interim final rule came in the the waning hours of the Bush
Administration, and was published in the Federal Register on Jan. 16.
While the Medicare Improvements for Patients and Providers Act (MIPPA)
of 2008 was able to secure a 18- to 24-month delay NCB, it did not
repeal or change the nature of program. MIPPA required CMS to terminate
the winning round one contracts from 2008 and essentially restart the
program. This rule announcing round one will be re-bid is the first
step in that process. The full text of the final rule can be downloaded or viewed as PDF at http://edocket.access.gpo.gov/2009/pdf/E9-863.pdf.

Upon entering office, one of the first acts of the new Obama administration was to delay all last-minute regulations passed by regulatory agencies during the
final days of the Bush administration. President Obama’s chief
of staff Rahm Emanuel issued a Jan. 21 memo to all federal agencies and
departments instructing them to hold all pending rules for 60 days
until the new administration can carry out a legal and policy review on
each.

The delay’s announcement comes after member of the HME industry testified before Congress as to how the competitive bidding program would hurt U.S. healthcare. That testimony was part of the American Association for Homecare’s Feb. 11 Washington Fly-in.

“While today’s delay gives the HME sector some temporary reprieve, everything about CMS’s handling of the competitive bidding program from the very outset has been troubling,” commented AAHomecare President Tyler Wilson.  “Starting with the mismanaged implementation in 2008, through the mischaracterization of the program as a fraud prevention effort, to the rush earlier this year on January 16 to ramrod the program through under the cover of the previous administration on its very last day, CMS seems intent on being confrontational with the HME community.  

“Now, with some respite in the process, I hope that CMS will circle back and conclude they should work with homecare providers through the PAOC and other means to make sure the reimplementation is free of flaws,” Wilson said.  “Or better yet, CMS should work with the HME community to convince Congress that the bidding program will harm beneficiaries and providers alike and should be scrapped.  AAHomecare continues to push Congress to terminate the bidding program altogether.”  

The interim final rule came in the the waning hours of the Bush Administration, and was published in the Federal Register on Jan. 16. While the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008 was able to secure a 18- to 24-month delay NCB, it did not repeal or change the nature of program. MIPPA required CMS to terminate the winning round one contracts from 2008 and essentially restart the program. This rule announcing round one will be re-bid is the first step in that process.

When first announced, CMS said in the interim rule that it has chosen to continue to apply the same methodologies of the program’s regulations, published in April, 2007, except for changes that were outlined per MIPPA. The round one re-bid would cover all the previous product categories from 2008, except for negative pressure wound therapy, and, per MIPPA, NCB no longer includes group three rehab power wheelchairs. In terms of MSAa affected, round one will include nine of its original competitive bidding areas, except for San Juan, Puerto Rico.

Additionally CMS provided a 60-day comment period that expires March 17.  That date remains unchanged, despite the extended effective date of the interim rule. Providers can submit comments about the program as outlined in the final rule.

AAHomecare stated when CMS first announced the interim rule that the 60-day comment period does not provide enough time for public discussion, “given the magnitude of the program and the many patient access to care, choice of provider, and quality of care issues at stake.”