Bipartisan concern on DMEPOS

From: Politico

By REP. GLENN THOMPSON and REP. BRUCE BRALEY

At a time when bipartisanship is rare in Washington, a majority of members of the U.S. House of Representatives recently came together in an attempt to ensure that the Centers for Medicare and Medicaid Services (CMS) does not put Medicare beneficiaries at risk, when implementing the Competitive Bidding Program for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS). This bipartisan group, made up of 82 Democrats and 145 Republicans, is urging CMS to delay further implementation of the DMEPOS  Competitive Bidding Program, citing identified abuses and outlining concerns  over the agency’s ability to appropriately screen suppliers. Unfortunately, rather than respond, it appears that CMS has decided to run a public relations campaign.

On Monday, CMS Deputy Administrator Jonathan Blum, writing in POLITICO, defended the abuses. Wrote Blum: “The competitive  bidding program carefully checks suppliers to ensure they are in good standing with Medicare, meet quality and financial standards – and are licensed and  accredited.” Unfortunately, the evidence by all accounts points to the  contrary.

In Tennessee, CMS awarded contracts to 30 unlicensed suppliers.  Since that time, CMS Administrator Marilyn Tavenner has indicated those contracts would be voided. However, the administrator failed to indicate whether bids by those companies would remain, potentially skewing the price point for  each product. After removing 30 of the 98 contracts in Tennessee, Tavenner  stated that adequate coverage for beneficiaries in the state would still be available moving forward. If that were truly the case, it certainly begs the question of why so many contracts were awarded in the first place.

CMS’s reaction to admitted misconduct in the DMEPOS program has been lackluster. CMS officials continue to laud the projected savings under the  bidding model, yet fail to answer the very serious questions we, as elected  representatives, have a responsibility to ask. While CMS would like the public  to believe Tennessee was an isolated incident, additional reports of unlicensed suppliers winning bids in Ohio, Maryland, Michigan, California, and Florida have  followed. Just recently, it has been brought to light that close to 60 percent  of the suppliers who won contracts in the Philadelphia market are unlicensed to  provide services in Pennsylvania.

For these many reasons, we have called for a formal investigation by Health and Human Services Inspector  General Daniel Levinson. The public must be assured that there are legitimate  reasons behind the insistence of moving the program forward, despite the growing  number and systemic nature of the abuses.

We acknowledge the government should take every measure to reduce costs.  Furthermore, we believe the Medicare DMEPOS program is unsustainable without the  introduction of competitive market methods and other common sense reforms.  Savings can and must be achieved through a manner that protects beneficiaries’ access to quality goods and services. But to say the current model achieves this  end without knowing to what expense on the part of beneficiaries is a slap in  the face to good government.

In 2011, more than 240 economists and market auction design experts wrote  President Obama on the issue, warning that Medicare’s new bidding model would  ultimately harm competition and impair patient access, stating “the current  program is the antithesis of science and contradicts all that is known about  proper market design.” These perceived flaws have now become a reality.

Medicare beneficiaries and taxpayers deserve a system that’s not just labeled  competitive, but is competitive. We stand by our letter, as do 225 other members  of Congress, and again urge the CMS administrator to do the right thing and delay the program to allow for adequate investigation and correction of these  significant problems before moving forward in 100 cities nation-wide.

Rep. Glenn Thompson (R-Pa.) and Rep. Bruce Braley (D-Iowa)