U.S. Senators John Thune (R-South Dakota), Robert Casey (D-Pennsylvania), and John Hoeven (R-North Dakota) today led a bipartisan group of 34 Senators in sending a letter to Centers for Medicare and Medicaid Services (CMS) Administrator Marilyn Tavenner calling on CMS to hold off on expanding the CMS Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) competitive bidding program until the Health and Human Services Office of Inspector General (OIG) can examine the Round 2 bidding process.
Following the implementation of Round 1 competitive bidding, a number of concerns were raised regarding the DMEPOS competitive bidding process. The concerns range from a lack of transparency, to improper financial vetting of contract firms, to design flaws. These concerns prompted Congress to mandate that CMS re-bid Round 1 in the nine selected metropolitan areas. The OIG investigated the Round 1 rebid and published its analysis in April of 2014. Round 2 bidding for 91 areas in the United States became effective on July 1, 2013, and this letter requests that CMS waits until the OIG has published its review of Round 2 before expanding the program nationwide. It is imperative that Congress can analyze and understand how this program is working before implementing across the country.
The senators write, “We appreciate that CMS is requesting input before moving forward, especially given the impact competitive bidding prices could have on rural areas. In these remote areas, DMEPOS are especially vital and necessary to resident beneficiaries, and we question whether an apples-to-apples comparison with urban areas is the best approach... 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 single payment amounts and give Congress time to review the results.”
Thune, Casey, and Hoeven were joined in sending the letter by Senators Lamar Alexander (R-Tennessee), Kelly Ayotte (R-New Hampshire), Tammy Baldwin (D-Wisconsin), Michael Bennet (D-Colorado), Roy Blunt (R-Missouri), Richard Burr (R-North Carolina), Ben Cardin (D-Maryland), Saxby Chambliss (R-Georgia), Dan Coats (R-Indiana), Thad Cochran (R-Mississippi), Mike Crapo (R-Idaho), Joe Donnelly (D-Indiana), Mike Enzi (R-Wyoming), Deb Fischer (R-Nebraska), Chuck Grassley (R-Iowa), Heidi Heitkamp (D-North Dakota), Mazie Hirono (D-Hawaii), Jim Inhofe (R-Oklahoma), Johnny Isakson (R-Georgia), Mike Johanns (R-Nebraska), Tim Johnson (D-South Dakota), Angus King (I-Maine), Joe Manchin (D-West Virginia), Jerry Moran (R-Kansas), Rob Portman (R-Ohio), Pat Roberts (R-Kansas), Marco Rubio (R-Florida), Brian Schatz (D-Hawaii), Tim Scott (R-South Carolina), Pat Toomey (R-Pennsylvania), Mark Udall (D-Colorado), David Vitter (R-Louisiana), and Roger Wicker (R-Mississippi).
The text of the senators’ letter follows:
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May 20, 2014
Marilyn Tavenner
Administrator
Centers for Medicare and Medicaid Services
Hubert H. Humphrey Building
200 Independence Avenue, SW
Washington, DC 20201
Dear Administrator Tavenner:
On behalf of Medicare beneficiaries and the durable medical equipment providers who provide services and supplies in our states, we write regarding the advanced notice of proposed rulemaking recently issued by the Centers for Medicare and Medicaid Services (CMS) titled, “Medicare Program; Methodology for Adjusting Payment Amounts for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) using Information from Competitive Bidding Programs” (RIN 0938—AS05). In this advanced notice, CMS asked for input on the Competitive Bidding program in advance of expanding the program nationally which must occur by January 1, 2016.
We appreciate that CMS is requesting input before moving forward, especially given the impact competitive bidding prices could have on rural areas. In these remote areas, DMEPOS are especially vital and necessary to resident beneficiaries, and we question whether an apples-to-apples comparison with urban areas is the best approach, especially since there are some concerns with the bidding process in Round 1 and Round 2.
The Health and Human Services Office of Inspector General (OIG) is currently examining 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 single payment amounts and give Congress time to review the results. It is important that we have the guidance of this review before moving forward with a national program.
We look forward to your response.
Sincerely,