Senate Staff Should Bring Tough Questions to CMS Briefing on Bidding Program March 14

The Centers for Medicare & Medicaid Services (CMS) will give U.S. Senate staff an update on Rounds One and Two of the dangerously flawed HME “competitive” bidding program on Wednesday, March 14 at 2:00 p.m. The briefing will be held the Dirksen Senate Office Building, Room SD-430.

We are urging HME providers to alert their Senators about the importance of this briefing. This is our opportunity to explain the negative consequences of Round One in terms of patients’ reduced access to homecare, the harm to HME providers, and alarm about the spread of the bidding program to 91 additional areas in Round Two.

Please ask that your Senators’ health legislative assistants 1) attend the briefing, 2) ask CMS tough questions about the program, and 3) request that CMS release additional information about bidding program.

If you would like more information about the briefing, please contact Jay Witter at jayw@aahomecare.org, 703-535-1884.

MPP: 'It's time to be all in'

HME News outlined the importance of attending the AAHomecare Washington Legislative Conference:

In a make or break effort to bring home medical equipment providers to the Hill next week to stump for an alternative to competitive bidding, AAHomecare is making its Washington Legislative Conference virtually free.

"It's time to be all in," said Joel Marx, chairman of AAHomecare and president of Cleveland-based Medical Service Co. "If we don't get it done now, we're not going to get it done."

HME Business also quoted AAHomecare chairman: “We’re at a critical juncture when it comes to Congress giving full consideration to the Market Pricing Program as a credible alternative to the current bidding program,” said AAHomecare Chairman Joel Marx, who is also Chairman of Cleveland-based Medical Service Company. “The homecare community needs to have a strong turnout on Capitol Hill in mid-February. If HME companies fail to make the case, we’re going to have a difficult time stopping the bidding program from moving forward with full force into Round Two.”

Wall Street Journal Bashes the Bidding System

Today’s lead editorial in The Wall Street Journal describes the design of the current Medicare bidding program as “idiotic and designed for failure.” The scathing critique praises the concept of competitive bidding but notes that Round One (what it calls the “pilots”) was a disaster. “Medicare cooked up an auction process that defies all economic sense.”

“The current nationwide rollout has no substantive revisions from the failed pilots, despite the objections of 244 economists and auction scientists led by the University of Maryland’s Peter Cramton. The consensus of basically everyone who knows anything about auctions is that the no-risk bids and median pricing are idiotic and designed for failure.”

The link to the text and online comments is here.

CMS Will Abandon Pre-Pay Phase of Power Mobility Demonstration

In response to comments from AAHomecare and other stakeholders, the Centers for Medicare and Medicaid Services (CMS) today announced two key changes to the prior authorization demonstration for power mobility devices (PMD). The key modifications are:

• CMS has removed the prepayment review phase (phase 1) of the demonstration and will go straight to the prior authorization phase.
  
• The PMD provider will be allowed to submit the prior authorization request to CMS on behalf of the physician.
  

CMS expects the PMD prior authorization demonstration to begin on or after June 1, 2012, in the seven states impacted in the demonstration (California, Florida, Illinois, Michigan, New York, North Carolina, and Texas).

Tyler Wilson, AAHomecare president, stated, “We appreciate that after our numerous conversations with CMS, the Agency has responded to many of the concerns expressed by the HME sector. We look forward to working with CMS to ensure that the prior authorization demonstration is implemented in a way that is effective without negatively affecting beneficiaries and HME providers.”

CMS PMD demo page

Summary of the modifications

Text from the announcement follows, excerpted:

Prior Authorization of Power Mobility Devices (PMD) Demonstration

CMS received many comments/suggestions on the Prior Authorization of Power Mobility Devices (PMDs) demonstration. The CMS has considered these comments carefully.

In response to comments received from stakeholders, the CMS has made a number of modifications to the Prior Authorization of PMD demonstrations.

• The CMS has completed a separate Paperwork Reduction Act (PRA) notification for this demonstration and the Recovery Audit Prepayment Review demonstration.
  
• The CMS has removed the 100% Pre-Payment review phase (formerly Phase 1). All modifications that had previously been made to Phase 1, are no longer necessary or applicable as a result of the removal this phase.
  
• The CMS will allow suppliers to perform the administrative function of submitting the prior authorization request on behalf of the physician/ treating practitioner.
  
• This demonstration will begin only after an OMB PRA control number is obtained. The CMS anticipates the start of this demonstration will be on or after June 1, 2012.
  

To submit questions regarding the demonstration contact: PAdemo@cms.hhs.gov