A Bidding Train Wreck

The home care community has been advocating a suspension in round one of bidding, armed with critical economic studies, projections of thousands of lost jobs and likely harm to patient access and quality. Now we're addressing the impact of round one payment amounts, which includes deep reimbursement cuts and wide price variations, and what appear to be serious flaws in the mechanics in the bidding process.

Within minutes of the overnight letters from the Centers for Medicare and Medicaid Services landing on desks of round one bidders on March 21, the American Association for Homecare began hearing examples of bidders who were stunned to learn that they had been disqualified because of missing financial data, even though the bidders provided all of the right information and carefully documented their submissions.

In a sense, being disqualified is worse than losing. It means your bid wasn't even considered.

Since March 21, the association has been collecting examples of bidding problems in round one to share with CMS and with Congress. On March 26, AAHomecare sent a letter to CMS Acting Administrator Kerry Weems asking him to extend the 10-day contract acceptance window for those providers who were offered contracts.

In the letter, we outlined the problems that we have heard from more than 100 round one bidders who may have been improperly disqualified and encountered other serious problems. We also requested an immediate meeting with CMS to find how to examine and address errors in round one.

Of course, there are deeper and broader problems with the bidding program. With CMS optimistically trumpeting deep savings for Medicare and announcing high levels of participation for small providers, there is no way the average person would know the legacy that competitive bidding is much more likely to leave:

• Thousands of small providers going out of business and thousands of jobs lost.

• Less competition in the durable medical equipment field.

• Fewer choices for consumers.

• Less certainty and greater complexity for seniors who require home medical equipment under Medicare.

• A weaker, less robust national infrastructure for providing home medical equipment.

• And ultimately — higher costs for Medicare and taxpayers.