The Secrets They Keep
"For a long time now, there's been too much secrecy in this city. ... That era is now over. Starting today, every agency and department should know that this administration stands on the side not of those who seek to withhold information but those who seek to make it known." - President Barack Obama.

It seems as if the Centers for Medicare and Medicaid Services (CMS) has not gotten the message. Or they think that being in Baltimore makes them exempt from Presidential directives. Either way, the agency is clinging to a secrecy policy developed during the previous administration that is counter to the President's Open Government Directive as well as a plain reading of the relevant statute.

In brief, home medical equipment suppliers are not allowed to receive competitively bid Medicare contracts unless they meet CMS' financial qualification standards. CMS, however, won't disclose those standards. Because CMS is able to disqualify any bidder based on secret standards, there is no competitive bidding system, there is only an elaborate process that allows CMS to pick and choose whichever suppliers they prefer.

A member of the Congressional-mandated advisory and oversight committee for the program told the agency that "we clearly need to know how CMS is going to use the standards, otherwise there will always be the appearance of subjectivity. ... We do worry that CMS has a perception problem as long as they keep these issues hidden from public scrutiny. The public has to have confidence that CMS is abiding by one set of standards for the HME sector."

After CMS told the panel to "give us a concrete proposal" regarding the financial standards, a regulatory watchdog informed the agency that "CRE has provided you with nine pages of concrete-we furnished you with a petition that detailed the statutory requirements which compel release of the financial standards."

CMS has indicated that they don't want to release the financial standards out of concern that the information would result in suppliers providing false data to "game" the system. It is difficult to know what is more disturbing, CMS' apparent inability to detect fraudulent data or their refusal, so far, to recognize that elections have consequences.

See CRE Testimony