Sen. Wyden Indicates CMS Incapable of Adequately Screening DME Providers

Sen. Ron Wyden (D-OR) sent a letter to CMS Administrator Berwick urging him to use authority in the new Affordable Care Act “to issue a temporary moratorium on enrollment of new durable medical equipment (DME) suppliers in the Medicare program while ensuring beneficiary access is not compromised.  Limiting the enrollment of new DME suppliers will go a long way in assisting CMS’ fraud and abuse prevention activities.”

The letter goes on to state that “[w]hile the competitive bidding program which is soon to be operational in 9 areas across the country…should help ensure that only legitimate providers are serving Medicare beneficiaries, further restricting the proliferation of fly by night operations–such as through a national moratorium on new entrants into Medicare–will go toward strengthening program integrity.”

Sen. Wyden’s letter contradicts itself.  If Medicare is as utterly incapable of screening the legitimacy of suppliers as the letter implies, then the competitive bidding program does not help “ensure that only legitimate providers are serving Medicare beneficiaries….” 

Since Sen. Wyden believes Medicare incapable of effectively screening suppliers, he raises the possibility that the winning bidders may include any number of “fly by night” or otherwise fraudulent companies.  By the Senator’s own logic, the Round 1 Rebid results should be scrapped.  To allow the competitive program to go forward before major reforms would result in Medicare beneficiaries being trapped by being allowed access only to a limited number of possibly fraudulent providers — unable to continue with their current legitimate DME providers who have proven themselves capable of meeting beneficiary needs.

The Wyden letter is attached below.