Competitive Bidding: The PAOC Perspective

When President Bush signed the Medicare Modernization Act (MMA) in December 2003, the nation focused on the law's unprecedented prescription drug benefit for Medicare. But buried in the mammoth legal document is a provision mandating competitive bidding for DME. Bidding will begin in 10 top metropolitan statistical areas (MSAs) in 2007 and move to 80 MSAs in 2009, after which the program could expand nationwide.

The government isn't doing this in a vacuum. The law requires the Centers for Medicare and Medicaid Services (CMS) to form a Program Advisory and Oversight Committee (PAOC) to advise the agency on implementing the competitive bidding program, along with quality standards that providers will eventually need to meet in order to maintain their Medicare supplier numbers. The committee held its first meeting in the fall and will meet periodically through 2009.

Observers have argued the group is ill-named: Some members say they're playing a purely “advisory” role and have no “oversight” over CMS. Other critics have said the committee's supplier delegation is light: Only a few out of 22 people chosen for the panel represent DME providers. But no one doubts the insight many committee members have. They come from both public and private sectors, including providers and manufacturers, state government and federal agencies.

Industry advocates are hoping CMS uses this insight to its advantage, so HomeCare contacted PAOC's members to ask what each personally hopes to bring to the table. A few didn't respond. But 16 committee members did have something to say, and their answers — some surprisingly candid — follow.

HomeCare's Question:

What is the main message you hope to convey to CMS about competitive bidding and its implementation?

“We obviously don't support competitive bidding, but CMS has no choice.

“Our objective is to make sure CMS understands as many details as possible to make sure this does not dramatically alter the marketplace. That's why the issue of quality standards is so important. [Those standards] are the only thing that will ensure that a beneficiary will have continued access to quality items. When you sit through these committee meetings, you realize the task is huge.”
— Cara C. Bachenheimer, JD, vice president, government relations, Invacare, Elyria, Ohio