WASHINGTON – Two national associations are raising concerns about the second phase of a competitive bidding program to be implemented by the Centers for Medicare & Medicaid Services.
The bidding program is designed to help lower Medicare beneficiaries’ out-of-pocket costs and improve their access to certain high-quality durable medical equipment, prosthetics, orthotics and supplies. Fully implemented, it could save beneficiaries and Medicare $1 billion annually, CMS predicts.
“We are deeply concerned that CMS is expanding a program before the first phase has started and the impact on beneficiaries’ access to supplies has been evaluated,” said Stephen J. Ubl, president and CEO of the Advanced Medical Technology Association.
The program enables CMS to prevent dishonest suppliers from participating in the Medicare program. The American Association of Homecare supports CMS in its current actions, but questions why it has taken Medicare so long to impose effective measure to prevent fraud.
“Medicare needs to stop giving supplier numbers to criminals, especially in places where it is obviously a problem, such as Miami. That will help cut down fraud immensely,” said Michael Reinemer, vice president of communications and policy for the home care group.
Some 70 new areas across the nation will take part in the expanded bidding program, CMS said. Ten areas currently participate in the program, providing greater beneficiary access to certain DME, prosthetics, orthotics and supplies, including standard and complex power wheelchairs, walkers, oxygen supplies and equipment, hospital beds and certain devices.
Suppliers must meet quality standards established by CMS in 2006 and be accredited by one of 10 organizations chosen by Medicare.
"Competitive bidding means that Medicare beneficiaries will have access to these products at substantially lower costs," said CMS Acting Administrator Kerry Weems. "Since all successful bidders will be required to meet quality standards and be accredited by Medicare, people with Medicare in these 70 new areas can be assured of access, low prices and high quality. Through this accreditation process, our beneficiaries are also provided another layer of protection from fraud."
However, there are conflicting views on whether fraud detection will be effective. For example, Reinemer believes that when accreditation is implemented nationwide, the bar will be raised high enough “to prevent criminals from getting Medicare supplier numbers.”