Competitive Bidding Committee Finds More Questions than Answers at December Meeting

Baltimore

Which products should be selected and where it should take place are among the issues a committee advising CMS on how to implement DME competitive bidding is contemplating. But after a two-day meeting in early December, the Program Advisory and Oversight Committee (PAOC) came up with more questions than answers.

• Quality Standards

  Above all else, quality standards remain the keystone for the competitive bidding process, committee members said.

  “We're putting the cart before the horse if we don't do the quality standards first,” said committee member Seth Johnson, director of government affairs for Exeter, Pa.-based Pride Mobility.

  Under the Medicare Modernization Act, suppliers must meet certain quality standards to participate in competitive bidding, and must receive accreditation to participate in the Medicare program, though exactly what those quality provisions will be and when they will be enforced remains fuzzy.

  A CMS official said quality standards “are the highest priority for the PAOC,” and will be a recurring item on future meeting agendas.

  He added that there was also “a lot of discussion and concern about the level of services, but I didn't hear what services we should be safeguarding. Those are specific details we'll need from suppliers.”

  The official said that if providers give details on services required for specific DME, then those services will be incorporated into the bidding contract. “If we find out a supplier is not providing the services, then they're gone,” he said.

• Which Products?

  The MMA gives the government the authority to exempt products that would not yield savings under a bidding program, but does not name specific products. So CMS and North Carolina-based contractor Research Triangle Institute, which is advising the agency on the bidding process, began asking questions: Which products should be placed for bid, and how? Should suppliers bid by HCPCS code or by more general product categories?

  Although no one recommended products that should undergo bidding, some recommended those that shouldn't — at least not in 2007, meeting attendees said.