CMS announced that the April 18 effective date still stands for its interim final rule to re-bid round one of competitive bidding.
After the Medicare Improvements for Patients and Providers Act (MIPPA) of July 2008 secured a delay to NCB and required CMS to terminate the winning round one contracts, it also essentially still required CMS to restart the program. So, CMS issued its interim final rule with comment period (IFC) on Jan. 15 as the first start in that process.
Seen as an eleventh hour regulation in the final days of the Bush administration, the IFC was delayed when the Obama administration issued a Jan. 21 memo to all federal agencies and departments instructing them to hold all pending rules for 60 days so that it could conduct a legal and policy review on each.
“Based upon its review and on the need to ensure that CMS is able to meet the statutory deadlines contained in MIPPA, the Administration has concluded that the effective date should not be further delayed,” read a public statement from CMS. “The rule will become effective tomorrow, April 18, 2009. However, there will be no immediate effect on the Medicare DMEPOS benefit and Medicare beneficiaries may continue to use their current DMEPOS suppliers at this time.”
The agency went on to say that it had in coming weeks will issue further guidelines and a timeline for re-bidding round one, and that in finalizing it would “continue to seek input from all affected stakeholders to ensure program implementation consistent with the legislative requirements.”
During the delay and comment period, the industry launched multiple efforts urging Congress, CMS, HHS and the Obama administration to halt and either change or eliminate the program. The most recent of these efforts was a House sign-on letter authored by Rep. Betty Sutton (D-Ohio) and signed by 84 congress members. CMS’s announcement at the last minute (again) that it would continue with the IFC left the industry taken aback, but still in the fight.
“Given the significant problems with the program highlighted over the past year, and in light of the repeated concerns expressed by Congress in 2008 and more recently, we are surprised by the CMS decision to move forward,” said American Association for Homecare president Tyler Wilson. ”We are working with Congress to stop this bidding program because it fundamentally misrepresents the durable medical equipment benefit as equipment-only instead of recognizing the integral services that are essential to providing quality care to seniors and people with disabilities who live at home.
“We will also work closely with the Obama administration to make sure that the Department of Health and Human Services and the White House review this program and take into account the numerous concerns expressed by patient and provider groups.”
Medical equipment manufacturer Invacare added that there is still time and opportunity to work to change the program.
“In our view, CMS did exactly what we predicted: while the IFR is ‘effective,’ we believe CMS will take no further action on implementing the bid program until it has completed its review of all the comments to date,” read a statement from Invacare. “We believe CMS will continue its dialogue with all stakeholders, including beneficiaries, physicians, industry and other interested parties. This will allow the incoming Obama Administration team at HHS and CMS to review the IFR which was first developed by the Bush Administration.”