The Centers for Medicare and Medicaid did not rescind the controversial competitive bidding rule before it was scheduled to go into effect on April 18, despite urging from Congress.
“In the upcoming weeks, CMS will be issuing further guidance on the timeline for and bidding requirements related to the Round 1 re-bid. In finalizing these guidelines, CMS will continue to seek input from all affected stakeholders to ensure program implementation consistent with the legislative requirements,” said CMS officials.
An April 16 letter signed by more than 80 members of Congress indicated there would be negative impacts for patients and businesses if the rule was allowed to go into effect.
Critics say the interim final rule, published by CMS on January 16, did not allow enough time for stakeholder comment.
According to the letter, the bidding program, which was suspended by Congress in 2008, would lower quality and reduce access to care for seniors and people with disabilities. It said the current version of the bidding program will put at least 90 percent of providers out of work at a time when unemployment is high.
“As growing numbers of seniors enter the Medicare program, it is important that we take care to maintain an adequate number of qualified and capable providers to address demand for care in the home, especially in rural areas,” said Rep. Betty Sutton, (D-Ohio).
According to the letter, the program’s current structure bears no resemblance to 1997 and 1998 demonstration programs in Florida and Texas and is anti-competitive because it would selectively contract with a small group of homecare providers based on the lowest bid, forcing out providers who use high-quality homecare equipment or provide critical patient services.
Of the more than 4,000 providers in the initial bidding areas, only 376 were deemed to have met the bidding program requirements.
According to the American Association for Homecare, spending on home medical equipment and care is the most cost-effective and slowest-growing portion of Medicare, increasing only 0.75 percent per year.
That rate compares to more than 6 percent annual growth for Medicare spending overall. DME represents only 1.6 of the Medicare budget.
“Given the problems highlighted in recent months and the congressional concerns, we are surprised by the decision to move forward,” said AAHomecare President Tyler J. Wilson. “However, AAHomecare continues to work with members of Congress and the Obama administration to address the numerous flaws with the bidding program.”