DME Users Voice Hardships of CMS Competitive Bidding Program
Users of durable medical equipment (DME) have called upon a home health advocacy group in their efforts to voice hardships caused by the latest round of the Centers for Medicare & Medicaid Services (CMS) Competitive Bidding program.
Round 2 of CMS’s Competitive Bidding Program went into effect July 1, 2013, and since then more than 2,000 patients have called an organization, People for Quality Care, seeking assistance for DME products that have become limited in certain areas as a result of the Medicare bidding program.
In some circumstances, Medicare beneficiaries have encountered difficulties in acquiring new devices such as power wheelchairs in their area due to a number of providers that were not able to secure winning bids to serve certain geographical areas.
Other beneficiaries have claimed that even when they did receive the new equipment they requested from a new DME provider, often times the device was not the right size, or the closest provider required beneficiaries and their family members to travel farther to pick up the equipment from a wining bid provider.
But through all of the complaints, it appears as if CMS is blind to the struggles at hand, according to the American Association for Homecare.
“It’s disturbing that CMS is claiming everything is fine when people are suffering,” said Tom Ryan, president of AAHomecare. “The bidding program is bad public policy that needs to be fixed or stopped.”
A May 2012 report from the Government Accountability Office (GAO) suggested that CMS may be intentionally undercounting the number of problems it has received in response to its Competitive Bidding program.
“CMS’s definition of inquiry and complaint may be an optimistic characterization of beneficiary calls,” the report states. “According to CMS, all calls are first classified as inquiries and are only classified as complaints when they remain unresolved by CSRs [customer service representatives].”
As individuals who utilize DME products are often a more frail and older population, home health advocacy groups like AAHomecare and the National Association for Home Care & Hospice have argued that these individuals might even have to leave their homes and instead receive care in more costly institutions, such as nursing homes or hospitals if their conditions worsen.
“CMS must acknowledge the real problems that Medicare patients are encountering,” Ryan said. “How can they expect anyone to believe that they have only received a handful of complaints when more than 2,000 people have reached out to a private organization for help addressing their problems?”
Written by Jason Oliva