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LAS VEGAS--As the reality of Round 1 grows closer—CMS should release pricing in June—the hottest topics at Medtrade Spring last week were competitive bidding, competitive bidding and competitive bidding.
“It’s really appropriate that we’re talking about competitive bidding in Las Vegas, because it’s one huge gamble,” said provider Diana Guth, owner of Los Angeles-based Home Respiratory Care. “For those of us who have run our companies so carefully and so responsibly to have to participate in competitive bidding is bigger than any gamble we can take at the poker tables or the slot machines. It’s really sad.”
Alan Morris, regulatory analyst for Waterloo, Iowa-based VGM, agreed. “Competitive bidding changes who gets to bill Medicare and how much they get paid for it,” he told a packed room during a session on accepting bid contracts (or not).
Providers are “really behind the eight ball,” Morris said, adding that “it’s not unreasonable to say we might be looking at 25 percent cuts” resulting from Round 1. HME companies that rely on Medicare are “basically being put in an impossible situation because if they lose a bid, they’re out of business,” he said.
Continuing tension over the controversial program spilled over as Medtrade Spring attendees—nearly 5,000 providers, manufacturers and others attached to home health care—crowded every session on the topic at the annual show, held May 11-13 at the Sands Expo & Convention Center.
At a CBIC update Wednesday morning, frayed emotions showed as presenter Carmen Soto-Ortiz, competitive bidding ombudsman from Palmetto GBA, was peppered with questions from a contentious audience throughout the hour-long session. While little new information emerged, Rob Brant of City Medical Services in North Miami Beach, Fla., and president of the Accredited Medical Equipment Providers of America, got one answer he didn’t want.
Brant explained that an AMEPA member had received a letter from the CBIC questioning a low Round 1 bid for gastrostomy tubes, part of the enteral nutrients, equipment and supplies category. The provider realized he made a “typographical error” in submitting the bid, Brant said, pointing out that the weight of the items in question is only a minor part of the overall bid category.
“Ninety-nine percent of the enteral bid category is made up of enteral feed formulas and feeding supply kits,” Brant told Soto-Ortiz. “Even when the current reimbursement is multiplied by the weight, the result to the overall bid is less than 1 percent … Will this bid be disqualified?”
“At this time bids cannot be adjusted or re-submitted, and no further changes can be permitted,” Soto-Ortiz responded, noting that “the error will likely result in disqualification from that category …
“Every item, no matter how small of a weight, affects the bid,” she said.
Perhaps the only good news about the bidding program? “I think that there’s almost a 100 percent chance that at some point in the relatively near future, this program is going to fall on its face,” said VGM’s Morris, pointing to the momentum H.R. 3790 to repeal competitive bidding has gained in the House of Representatives. As of Friday, the bill had 237 cosponsors.
Even if the bidding program does move forward, Morris said, “I think that’s it going to be much like last time. It’s going to be such a debacle … that it’s impossible to foresee a scenario in which our legislators don’t step in,” he said. “They understand it’s a bad program.”
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