AdvaMed to CMS: Slow Down on Competitive Bidding

WASHINGTON--Echoing concerns voiced by industry advocates for months, the Advanced Medical Technology Association told CMS that, with only a year left to prepare for Medicare DME competitive bidding, it is concerned the agency is rushing work on the project and fears that attempting to implement the program in January 2007 could be "counterproductive."

In a Dec. 2 letter, AdvaMed Senior Executive Vice President David Nexon said his biggest worry is that the proposed rule on competitive bidding--originally expected to be released in the spring of 2005--has yet to be published, although competitive bidding is scheduled to begin in 10 of the country's largest metropolitan statistical areas at the start of 2007.

"We continue to be concerned that if CMS rushes to the finish line to implement the competitive bidding program, there will be increased potential for beneficiary and provider confusion, reduced beneficiary access to critical health care services and unnecessary disruption of the DME marketplace," Nexon wrote to Herb Kuhn, director of CMS' Center for Medicare Management.

"Under the best circumstances, if CMS continues with a January 2007 implementation date, months of important work will be condensed into a few short months," he continued.

Some of the work still to be completed, Nexon pointed out, includes: creating a process for accreditation of suppliers, identifying the accreditation organizations and allowing suppliers to complete the accreditation process; developing and issuing requests for bids; assessing and selecting participating suppliers; selecting the 10 MSAs where the program will take place; designing and contracting for operational and systemic changes for CMS, suppliers and manufacturers; and educating beneficiaries.

Nexon said he believes that the Medicare Modernization Act, which mandated DME competitive bidding, gives CMS the flexibility to begin the program any time during 2007. He also recommended that the agency should carefully select the initial MSAs to avoid the largest, most complicated areas that cross multiple state lines; limit the number of products subjected to competitive bidding during the early phases of the program; and allow as many suppliers as possible to participate in the early phases of the program so beneficiary access will not be compromised.