Unable to Justify Support for Competitive Bidding, NCHC Declines to Meet with CRE

The National Coalition on Health Care (NCHC), which describes itself as “America’s oldest, most diverse, and broadest based group working to achieve comprehensive health system reform” has proposed a major expansion of CMS’ competitive bidding program to “to the categories of durable medical equipment not included in the current program, including items such as nebulizers and ventilators.” NCHC also supports “reducing the rate at which the federal government reimburses state Medicaid programs for DME” to Medicare levels.

Because the CMS bidding program has been castigated by every independent expert which has examined it for its “complete lack of transparency,” failure to generate competitive results, and facing “a near certainty of failure,” CRE sent NCHC a letter inquiring as to why they were supporting its expansion. CRE explained that the organization’s response would be printed verbatim on the Competitive Bidding Interactive Public Docket.

Despite multiple requests from CRE to meet with NCHC to discuss their support for expansion of competitive bidding, the organization has not agreed to meet or responded to the CRE letter.

CRE concludes that NCHS has not responded to CRE’s letter or agreed to meet because they have nothing to say – their support cannot be justified. CRE finds it hard to believe that leading companies which are NCHC Partners, such as Verizon and CVS Caremark, would be opposed to even discussing the issue.

CRE has explored a number of options for correcting the deficiencies in the CMS program including: a petition to release the financial standards bidders are required to meet, testimony before the agency, a request for HHS review of the program, and litigation.

Now that H.R. 6490, the Market Pricing Program Act, has been introduced to fix the program’s fatal flaws, there is a need to demonstrate to Congress why the program requires Congressional review and correction. Thus, CRE will be filing a Data Quality Act petition against CMS’ arbitrary and uncompetitive methodology for selecting bid winners. Since there is no bar to judicial review of agency DQA decisions, CRE will litigate the agency’s actions regarding the petition if necessary.