Federal Judge: CMS appears “indifferent to, if not ignore entirely, the large number of individuals in the [USA] that are developmentally disabled and have other disabilities…

Editor’s Note:  In the Order and Memorandum attached here, a Federal Judge issued a blistering criticism of CMS’ management of the competitive bidding program.  The following are excerpts from the US District Court Judge Donovan W. Frank’s Memorandum and Order in Key Medical Supply, Inc. v. Sebelius et al.

While the decision on the motions is supported by law, the Court is deeply concerned about the unjust consequences of its order. As such, the Court feels compelled to issue a short memorandum herewith, prior to issuing its full memorandum and opinion.

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Judge criticizes Medicare bidding program

CMS Seeks 518% Budget Increase for Competitive Bidding

From: CRE

At a time of harsh budget austerity across the government, CMS is seeking more than a five-fold increase in their budget to expand competitive bidding.  HHS/CMS’ FY 2013 Justification of Estimates for Appropriations Committees budget document states: 

Expand Durable Medical Equipment (DME) Competitive Bidding: CMS is requesting $55.0 million, an increase of $46.1 million above the FY 2012 enacted level.  In FY 2013, under the second round, CMS will expand operations to 91 additional Metropolitan Statistical Areas (MSAs), for a total of 100 MSAs, and implement a National Mail Order competition.

If offered bidding contracts, 68% of providers say they wouldn’t accept

From: HME News

by: Leif Kothe

YARMOUTH, Maine – Two weeks after CMS’s announcement of severe cuts in Round 2 single payment amounts, providers were saying “no” to contracts.

In a recent HME NewsPoll, 68% of providers said they do not plan to accept a CMS contract for Round 2 of competitive bidding.

“A 45% decrease is impossible,” said Jack Lentz, clinical director at Southampton, Pa.-based Respiratory Therapy Services. “In fact, it’s criminal and should be investigated.”

Of the respondents who said they would not accept a contract, 39% said they plan to shift their focus to non-Medicare payers.

CMS Will See The Light When They Feel the Pain

Editor’s Note:  See the following article  appears in  Human Events.  Basically CMS believes they are untouchable and is going to proceed with an arbitrary pricing system wrapped in a bow titled “competitive bidding”. Senator Dirksen ( Circa early 60’s)  once stated that people “see the iight when they feel the pain”. It is time the regulated industry abide by Senator Dirksen’s comments with full recognition that since they are regulated it is best to work through credible  and recognized  third parties such as CRE.

New Medicare bidding rules, pricing raise objections

Medicare’s cost saving program could squeeze wheelchair, oxygen dealers out of business, they say

From: Cleveland Plain Dealer

By Stephen Koff, Plain Dealer Washington Bureau Chief

WASHINGTON, D.C. – A Medicare program that cut costs dramatically in Cleveland and a few other areas will expand to Akron, Youngstown, Columbus and dozens of other areas nationwide this summer, providing massive savings — $25 billion for the government and $17 billion for beneficiaries between now and 2022, federal officials say.

But the suffering that may result could be just as monumental, say businesses that supply power wheelchairs and scooters, walkers, oxygen concentrators, diabetes testing strips and similar home medical equipment. Just as it did in Cleveland in 2011, the government is going to pay a lot less for home equipment in 91 additional metropolitan areas starting July 1.

Institute of Medicine Warns About Counterfeit Diabetes Test Strips

Editor’s Note:  The National Science Foundation’s Institute of Medicine has just issued a pre-publication edition of a report, Countering the Problem of Falsified and Substandard Drugs, which discusses the dangers of counterfeit and other falsified/illegitimate medical products.  IOM notes that:

Poor quality medicines cause treatment failure, but doctors do not generally suspect Soma medicines as a cause of disease progression. Lifesaving medicines can be of poor quality, which may be an uncounted root cause of high mortality in low- and middle-income countries. No class of drug is immune to being compromised.

In-pharmacy Diabetic Sellers: The Handwriting on the Wall is Clear–Too Clear!

Editor’s Note:  For several years,  CRE has  been advising In-pharmacy sellers  of diabetic supplies  that the initiation of the CMS  competitive bidding program for durable medical equipment was aimed at their products.  After numerous discussions, most sellers  adopted a  let’s join a coalition and we will work it out strategy. Thoughtful discussions and considered strategy have little impact  without a strong regulatory intervention when dealing with an agency such as  CMS who does not act on the facts.

“Something smells extremely fishy with this entire Competitive Bidding Program”

Editor’s Note:  From a Comment by supergolfer on Theresa Flaherty’s HME News blog.

Well I am the Billing Manager of a small Mail Order Diabetic Supply Company that was extremely shocked at the reimburstment rates we to thought the pricing would come in at around $15.00 per bottle.

However I am even more upset that we have heard rumors that the bid winners already know who they are and that only 15 contract were awarded.

Something smells extremely fishy with this entire Competitive Bidding Program and almost sounds as though fraud hof some sort has been commited.

Test strip supply linked to better diabetes care

Editor’s Note:  The following article and forthcoming study in Diabetes Care should be viewed in context of the Theresa Flaherty’s story on HME News, “Bottom drops out of diabetes market: ‘There is no way (these suppliers) are going to get there’“

From: Reuters

Frequent blood sugar testing was strongly associated with better diabetes control in a large new study that concludes public and private insurers should not be limiting test strip supplies.

Particularly for people with type 1 diabetes, who must test their own blood sugar throughout each day and inject insulin to regulate sugar levels, a cap on the number of test strips they’re allowed to use may seriously affect their  health, researchers say.