Device-makers slam Medicare competitive bidding expansion

Editor’s Note: CRE has long warned about the expansion of un-competitive bidding.

From: Healthwatch/The Hill’s Healthcare Blog

By Elise Viebeck

The medical-device lobby is railing against a new expansion of Medicare’s competitive bidding program for durable equipment, a policy projected to save billions of dollars for beneficiaries and the Part B Trust Fund by 2022.

The Advanced Medical Technology Association (AdvaMed) said that the expansion could deprive patients of their preferred medical tools and tests.

“The competitive bidding program is built in such a way that the lowest  bid — which may not be the right bid — may compromise patient access to products best suited for their needs,” AdvaMed President Stephen Ubl said Thursday in a statement.

CMS Announces Sharp Price Cut for Mail Order Diabetic Supplies

Editor’s Note:  From the CMS Press Release, “Medicare beneficiaries across the country will save an average of 72 percent on diabetic testing supplies under a national mail-order program starting at the same time.” 

From: CMS

CSIHME acquired by NAIMES

From: Home Care Magazine

HALIFAX, Va., Jan. 28, 2013—The National Association of Independent Medical Equipment Suppliers (NAIMES) announces that it has acquired the Committee to Save Independent HME suppliers (CSIHME) and merged it into the national trade association. “We are pleased with this merger which will combine the resources of CSIHME with NAIMES,” according to NAIMES Chairman Wayne Sale. “This effectively doubles our resources and will improve the effectiveness of NAIMES as an advocate for its members in the independent supplier community.”

Sale also noted that the merger brings a renewed spirit of determination to the organization’s battle to replace the ill-fated national DME bidding process.

Mandatory mail order? Seniors concerned

From: HME News

ALEXANDRIA, Va. – A survey that suggests seniors are leery of mandatory mail-order pharmacy services may cast a long shadow on Medicare’s national mail-order program for diabetes supplies.

Respondents to the survey raised concerns about running out of medication, timeliness, and the possibility of medications getting lost in the mail or stolen.

“Mail order is not for everyone,” stated B. Douglas Hoey, NCPA CEO, in a press release. “In fact, consumers have said that it’s not for most people. Patients deserve a choice and they don’t like being told which pharmacy they have to use.”

AAHomecare discusses audits with GAO

From: HomeCare Magazine

WASHINGTON, D.C., Jan. 16, 2013—Last week the American Association for Homecare met with the Government Accountability Office (GAO) to discuss the post-payment audit problems that homecare providers face. GAO, which is the investigative arm of Congress charged with examining matters relating to the receipt and payment of public funds, is likely to issue a report on audits of Medicare providers later this year.

The GAO requested this meeting with AAHomecare to answer several questions from Congress regarding the extent to which CMS has established consistent post-payment claims review criteria across contractors, how CMS determines that contractors’ post-payment claims review criteria are valid and clear, and to what extent CMS prevents duplicative post-payment claim reviews.

Science News examines Medicare bidding program

From: Home Care Magazine

WASHINGTON, D.C., Jan. 10, 2013—The Jan. 7 issue of Science News attacks the mathematical underpinnings of Medicare’s competitive bidding program. According to the American Association for Homecare, the article by Julie Rehmeyer states that “Medicare could waste billions of dollars, bankrupt small businesses and leave seniors without crucial medical equipment, some economists warn, with a new auction-based purchasing plan that ignores mathematical principles of competitive bidding… As a bidder in this system, the rational thing to do is to bid really, really low. After all, your bid doesn’t determine what you’ll be paid.”

Devil is in the details of a new Medicare plan to buy medical supplies

From: Science News

By Julie Rehmeyer

Medicare could waste billions of dollars, bankrupt small businesses and leave seniors without crucial equipment like oxygen tanks and wheelchairs, some economists warn, with a new auction-based purchasing plan that ignores mathematical principles of competitive bidding.

The new plan began with an apparently good idea: Medicare has started buying durable medical equipment through a competitive bidding process rather than through fixed prices influenced by industry lobbying. In theory, this could save the government a big chunk of the $14 billion it has spent on such equipment in a year. But in reality, mathematicians and economists say, the bidding system Medicare has chosen is so flawed it will create chaos in the market, fail to meet the demand and waste money.

Velazquez introduces bidding repeal bill

From: Home Care Magazine

WASHINGTON, D.C., Jan. 3, 2012—Yesterday Rep. Nydia Velazquez (D-NY) introduced a bill, H.R. 27, to repeal the Medicare bidding program. The full text of the bill is not available yet but it is described as legislation “to amend title XVIII of the Social Security Act to repeal the Medicare competitive acquisition program for durable medical equipment and prosthetics, orthotics, and supplies (DMEPOS), and for other purposes.” Velazquez is the ranking member of the House Small Business Committee.  The bill was referred to the Small Business Committee in addition to the Ways and Means and Energy and Commerce committees. The American Association for Homecare is pleased that Congresswoman Velazquez recognizes the serious problems with the bidding program. It is committed to working with her and other members of Congress to stop the program and replace it with the Market Pricing Program (MPP). Learn more at www.aahomecare.org.

New sense of urgency for MPP

From: HME News

‘We have another bite of the apple’

by: Liz Beaulieu

WASHINGTON – With no time to lick their wounds, industry stakeholders are now targeting a must-pass bill to address a series of spending cuts as a potential vehicle for their market-pricing program (MPP).

The “fiscal cliff” deal, which did not include language to replace competitive bidding with MPP, delays $130 billion in automatic spending cuts until March 1. That gives stakeholders a small window to resurrect the program.

“Fiscal Cliff” Deal Has Consequences for Pharmacies

Editor’s Note:  Unfortunately, CRE’s repeated warnings about the expansion of competitive bidding are proving to be true.

From: Pharmacy Times

Daniel Weiss, Senior Editor