Senators’ Letter Pushes Against DME Competitive Bidding Round 2

A bipartisan letter from 36 U.S. Senators is calling for the Centers of Medicare & Medicaid Services (CMS) to hold off on expanding the agency’s competitive bidding program for durable medical equipment.

Led by Sens. John Thune (R-SD), Robert Casey (D-PA) and John Hoeven (R-ND), the letter urges CMS to halt the expansion of the bid program until the Health and Human Services Office of Inspector General (OIG) can examine the Round 2 bidding process.

“Before you move forward in implementing competitive bidding nationally, we request that you allow the OIG to complete their investigation on competitive bidding licensure problems and verification of Round 2 singly payment amounts and give Congress time to review the results,” the senators wrote. “It is important that we have the guidance of this review before moving forward with a national program.”

CMS’s competitive bidding program has become a center of controversy and opposition among Congressmen and providers of durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) since CMS launched the first phase of the program in nine different areas of the country in 2011.

Congressmen and DMEPOS providers alike have raised concerns regarding a lack of transparency, improper financial vetting of contract firms, as well as the program’s overall design structure that awards CMS contracts only to a select few providers in a geographic area.

The program has been subject to several investigations from the Department of Health and Human Services’ OIG, a most recent of which found that CMS had operated within the guidelines and Federal law when it rolled out its a re-bid version of the Round 1program for DME suppliers in 2009.

For 255 of the 266 DME suppliers who were awarded a contract, CMS “consistently” followed the appropriate procedures and requirements, according to OIG’s audit of the program.

Last week’s letter adds to the growing opposition for competitive bidding, joining other initiatives such as the Medicare DMEPOS Market Pricing Program Act of 2013 (H.R.1717), which looks to axe Round 2 and force CMS to adopt a market-based approach to determine prices for DMEPOS. 

The bill has been gaining steam and support since it was introduced by Rep. Tom Price (R-GA) in April 2013. Today, it has the backing support of 178 cosponsors.  

Earlier this month, Sen. Hoeven spearheaded a sign-on letter asking CMS to postpone its plans to expand the bid program nationwide by 2016. 

“I fear that competitive bidding will reduce the number of quality medical equipment providers in the country, therefore reducing beneficiary access to home medical equipment,” Hoeven wrote in the letter addressed to CMS Administrator Marilyn Tavenner.

View the most recent letter from Sens. Thune, Casey and Hoeven.

Written by Jason Oliva

Jason Oliva