U.S. Representatives are moving forward with a new bill that looks to delay the start of Round 2 of the Centers for Medicare & Medicaid Services’ (CMS) competitive bidding program for durable medical equipment (DME).
Last week, Reps. Glenn “GT” Thompson (R-PA) and Bruce Braley (D-IA) introduced H.R. 2375 after a letter—signed by 227 Members of Congress—sent to CMS Administrator Marilyn Tavenner detailing the bidding program’s failures and abuses failed to garner any administrative action.
The proposed legislation would force the CMS Administrator to rely moving forward with the implementation of Round 2 until the flaws identified with the program have been addressed and fixed.
Since the time that a bipartisan majority in the House sent their letter, Administrator Tavenner responded to members of the Tennessee delegation who also sent a letter expressing similar concerns with bid program, specifically as a number of DME providers that had been awarded contracts did not have necessary licensing in place that Round 2 requires.
“CMS has broken its own rules and the Administrator has neither addressed how these abuses occurred nor what corrective actions the agency will take,” said Thompson. “Unfortunately these failures are not limited to Tennessee, rather they illustrate widespread systemic flaws that have plagued the program.”
Similar instances where contract-winning providers lacked the proper license requirements to compete in Round 2 also occurred in South Carolina, Ohio, Maryland, Baltimore and Philadelphia—where at least 50% of winning providers were in violation of the rules.
“The Medicare bidding system the Obama administration is seeking to impose on medical equipment providers is deeply flawed, endangering small business and local jobs,” said Rep. Braley.
Another flaw of the program is that it imposes regional monopolies for providers, added Braley, which reduces choices for Medicare beneficiaries and threatens to replace local providers that are familiar with certain patients’ needs with faraway corporations.
In Hawaii, 74% of winning providers were on the mainland—more than 2,500 miles away from the patients they are supposed to serve, as reported by HME Business in late May.
The same could be said for New York, where more than 50% of the state’s winning providers were out of state, and where the average distance for those providers being 600 miles away.
“The free market should be allowed to work within Medicare, and that’s why we’ve introduced this bipartisan bill,” said Braley.
Written by Jason Oliva