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Industry Wary Of CMS Plan To Move Ahead With Competitive Bidding Program

This article was originally published in The Gray Sheet

Executive Summary

Home health care and medical product groups are urging CMS to protect Medicare beneficiary access to durable medical equipment and supplies now that the agency has detailed plans to cut prices for certain DME under its competitive bidding program

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Economists find flaws in DME competitive bidding

Pete Stark, D-Calif., chairman of the House Ways and Means Committee, is asking CMS Administrator Donald Berwick to consider making changes to the agency's competitive bidding process for durable medical equipment. Over the summer, CMS announced it would cut reimbursement an average of 32% for certain durable medical equipment categories under the first round of its competitive bidding program (1"The Gray Sheet" July 5, 2010). In a Sept. 28 letter to Berwick, Stark forwarded a Sept. 26 letter signed by 166 economists, computer scientists and other experts on auction practices who expressed concerns with the Medicare competitive bidding program. While the experts said they believe competitive bidding can be effective, they called for fixes. For example, they suggest, bids should be binding commitments to help weed out low-balling bids. "Successful government auctions emphasize transparency, good price and assignment discovery, and strategic simplicity," the group wrote

Economists find flaws in DME competitive bidding

Pete Stark, D-Calif., chairman of the House Ways and Means Committee, is asking CMS Administrator Donald Berwick to consider making changes to the agency's competitive bidding process for durable medical equipment. Over the summer, CMS announced it would cut reimbursement an average of 32% for certain durable medical equipment categories under the first round of its competitive bidding program (1"The Gray Sheet" July 5, 2010). In a Sept. 28 letter to Berwick, Stark forwarded a Sept. 26 letter signed by 166 economists, computer scientists and other experts on auction practices who expressed concerns with the Medicare competitive bidding program. While the experts said they believe competitive bidding can be effective, they called for fixes. For example, they suggest, bids should be binding commitments to help weed out low-balling bids. "Successful government auctions emphasize transparency, good price and assignment discovery, and strategic simplicity," the group wrote

Bill would tweak DME competitive bidding

Bill filed by Michigan Democratic Rep. John Dingell would help preserve in-house durable medical equipment services already offered by hospitals by allowing them to be compensated, whether or not they submitted a bid or were awarded a DME contract, at the rate determined by the Medicare competitive bidding process. The bill (H.R. 6095), which was introduced Aug. 10, was discussed by Dingell and others during a Sept. 15 hearing on DME competitive bidding by the House Committee on Energy and Commerce Subcommittee on Health. Dingell, who is chairman emeritus of the committee, has already received early support for the bill from organizations including the American Hospital Association. The hearing focused on the conception and implementation of the competitive bidding program, the implementation of the Round 1 re-bid and its potential effects on patients, providers and suppliers. Some legislators were encouraged by CMS testimony on how it has revised the program, but others continue to advocate ending competitive bidding in its current form, saying it will encourage systemic abuses, kill smaller DME distributors and hurt patient care. Home health care and medical product groups are among those who have been wary of the program 1("The Gray Sheet" July 12, 2010)

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