Congress is seeking a bigger role in plans by the Centers for Medicare & Medicaid Services to implement bidding among durable medical equipment suppliers.
On Wednesday, members of the House and Senate sent bipartisan letters to CMS requesting the release of data on how the new competitive bidding program will affect small DME suppliers.
The House letter, originated by Rep. Jason Altmire (D-Pa.) had 119 co-signers, including House Minority leader John Boehner (R-Ohio). The Senate letter, led by Sens. Sherrod Brown (D-Ohio) and George Voinovich (R-Ohio), had 17 co-signers.
The letters question whether CMS' efforts to protect the interests of small local suppliers in bidding processes set to award contracts to supply medical equipment to Medicare beneficiaries.
This month, CMS plans to award its first round of contracts, let out on the basis of competitive bidding and suppliers' ability to cut prices. CMS is rolling out the approach in 10 metropolitan statistical areas, or MSAs.
Medical equipment organizations have contended that the competitive bidding process favors large national firms and will freeze out small local suppliers that have supplied DMEs to beneficiaries in the past but are not able to service large MSAs.
The letters expressed concern that thousands of small local suppliers will not receive contracts and lose their ability to sell to Medicare patients, and it questioned whether these businesses would remain viable without the Medicare business.
"Although CMS and the Small Business Administration raised special considerations for small suppliers during the rulemaking process, we continue to believe that these steps will not guarantee adequate participation for small businesses," the House letter said.
"This will result in a number of small medical device providers going out of business, severely impacting patient access to the necessary equipment and quality care," the letter continued.
The Senate letter contends that a reduction in the number of small suppliers could increase costs to Medicare because small suppliers have closer relationships with individual beneficiaries and are more likely to provide personalized service and head off potential problems and errors.
In addition to asking for key economic data on the bidding program's impact, the House letter also expressed concern about CMS' plan to initiate the second round of contract awards before the first round has been fully implemented and its results can be evaluated.
CMS' plans call for the DME competitive bidding process to be used in 70 MSAs in 2009.
Altmire has also co-sponsored the Medicare Durable Medical Equipment Act (H.R. 1845), which would enable eligible suppliers to provide equipment and services at the lower competitive bid rate established by CMS, even if they were not originally awarded contracts through competitive bidding.
"There's no doubt DME competitive bidding looks good on paper, but I am still concerned about the long-term implications of the program," Altmire said. "CMS's implementation of DME competitive bidding could still compromise patient care and the quality service provided by small, local home medical suppliers. I look forward to continuing to work with CMS to ensure adequate small business participation."