Just for the record, we received more snow; but, compared to last week, we’ve barely felt Round Three of February’s worst. The real storm that threatens home care as we know it is national competitive bidding.
A well-respected HME provider and ten-year CAU client, Todd Tyson, recently authored his thoughts regarding the recurring NCB nightmare and what you can do about it. Here’s Part 1:
“Atlanta will soon begin the bidding process for the second round of Competitive Bidding (CB) for Medicare Home Medical Equipment (HME) slated to begin in Atlanta in 2011. CB was part of the Medicare Modernization Act (MMA) of 2003 that most of us recognize as the prescription drug bill which mandates that Medicare bid for home medical equipment and services. CB was originally supposed to begin in 10 Metropolitan Service Area (MSAs) in 2009 and expand to 80 more in 2010 including Atlanta however the program was so fatally flawed that Congress passed the Medicare Improvement for Patients and Providers Act (MIPPA) to postpone the implementation until 2010 so that the Centers for Medicare and Medicaid Services (CMS) could fix the problems inherent in the MMA.
“Sadly CMS has decided to move forward again with CB in 9 MSAs without any real improvement to the initial plan or process. The first round of bidding awarded contracts to providers that were not appropriately qualified or licensed to satisfy the regulatory requirements established by CMS supplier standards. Many winning bidders had never provided the services that they bid for and were awarded. Most did not have the credit necessary to fund the business and the growth required to satisfy the capacity that they were legally obligated to provide. One manufacturer was even quoted as saying that of the 380 winning bidders he would not extend credit to, more than 50% and several of the other 50% were already on credit hold.
“The original bid process was to yield a 27% saving to Medicare HME only because non-qualified underfunded bidders bid way below Medicare allowed fees. Some local providers bid low for fear that they would be barred from participation and other non-local providers bid even lower in order to eliminate local providers and gain new markets. No one truly understands why providers were willing to low ball bids, but the reality of the contracts was unsustainable for most bid winners.
“What does this mean for Medicare beneficiaries?” We’ll find out next time as we continue with Todd’s guest post. Meanwhile, you’re welcome to add your opinion to the conversation.
