GAO Report Highlights Need for Judicial Action and IG Investigation of Competitive Bidding

In a report on improper Medicare payments, the US General Accountability Organization (GAO) highlighted the need for judicial action to compel CMS to adhere to the law and use transparent standards and processes for evaulating DME providers seeking to win competitively bid contracts.  Specifically, GAO stated that CMS’ DME competitive bidding

program has the potential to help reduce fraud, waste, and abuse because it requires CMS to select DMEPOS suppliers based in part on new scrutiny of their financial documents and other application materials, among other things.

Unfortunately, any potential benefits from competitive bidding won’t be achieved under the current CMS regulatory regime since it does not actually use any known specific financial standards and employs an arbitrary bid selection processes.  The report highlights the need for judicial action on the DME provider lawsuit against CMS and an investigation of CMS’s refusal to disclose the financial  standards that bidders are required to comply with.  

The GAO report should have taken note of at least some of the fundamental failings of CMS’ DME program.