CMS Competitive Bidding Program Demands Attention

By Beth Bowen, NCAMES

Opinions surrounding Medicaid expansion and the implementation of the state’s Health Insurance Exchange are garnering a lot of attention, as well they should. Unfortunately, the same can’t be said for the Centers for Medicare and Medicaid Services (CMS) recently enacted and soon to expand competitive bidding program for certain durable medical equipment and services.

Through this competitive bidding program, CMS has issued major cuts in the medical equipment and services beneficiaries can receive. The program was initially launched last year in nine U.S. metropolitan areas, of which Charlotte was one. By July 1 of this year, the program will expand to 91 U.S. metropolitan areas including Asheville, Greensboro/High Point, Raleigh/Cary, and Northeastern NC/Southern VA.

In the initial nine metropolitan areas used as testing grounds, data shows that beneficiaries are waiting weeks for service from a provider that are often located more than 100 miles away. They receive lower-quality equipment and can no longer choose the equipment or provider that is best for them.

With competitive bidding, only some of North Carolina’s medical equipment companies will be allowed to provide services to patients – but only if they are willing to take a 45% CUT in costs. By dramatically limiting equipment companies in the bidding process, and with such dramatic cuts in equipment costs, thousands of North Carolinians will have issues accessing quality equipment and service from a home care provider.

The North Carolina Association for Medical Equipment Services (NCAMES) is focused on preserving access to safe, affordable, and therapeutic home medical equipment. We provide advocacy and education to home medical equipment (HME) providers statewide dedicated to helping North Carolina’s growing senior population and patients of all ages gain more mobility and experience a high quality of life in the comfort and privacy of their own homes.

Our nearly 300 members have a very clear and simple message regarding the CMS competitive bidding program:

1. The bid rates are bogus and unsustainable. No industry in America can take a 45% cut in revenue and survive.
2. There is a complete lack of transparency from CMS on how the winners were selected. These practices are unacceptable.
3. The current program must be STOPPED.
4. Our members and our industry offered and supports a replacement market pricing program (MPP).

To learn more about this critical North Carolina health care issue and what you can do to help, NCAMES invites you to join us for a roundtable discussion focusing on Medicare’s competitive bidding program for durable medical equipment (DME) and the affect it will have on both North Carolina home medical equipment businesses and Medicare beneficiaries.

When: Tuesday, Feb. 12, 6pm – 7pm

Where: Sheraton Raleigh Hotel, 421. S. Salisbury St., Raleigh, NC

 Who: Included in the discussion will be Medicare beneficiaries, clinicians, physicians, and DME providers

Representatives from all 13 NC Congressional districts, Senators Hagan and Burr, Governor McCrory, Lt. Governor Forest, and Sec. of State, Elaine Marshall have all been formally invited to attend.

The CMS competitive bidding program is bad for Medicare beneficiaries and is an unfair and unsustainable business practice. There are clearly a wealth of health care issues demanding the attention of North Carolina lawmakers and leaders, and we believe access to high quality durable medical equipment and services is chief among them.

Beth Bowen is Executive Director of North Carolina Association for Medical Equipment Services (NCAMES).