WASHINGTON--With just days left before Medicare's first-round competitive bidding window closes, there is blatant evidence that many providers still have critical questions and concerns about the bidding process.

But neither those concerns nor the glitches in the bidding system itself will be enough to stall the bidding deadline, a CMS official indicated last week.

A last-minute bidders' conference call sponsored July 9 by CMS turned into a blitz of questions on all aspects of bidding. Callers also expressed frustration at being frozen out of the online system as they tried to place bids.

Joel Kaiser, CMS deputy director of DMEPOS policy, told callers that the agency had extended the time-out period so providers could stay in the system for 12 hours before being automatically logged off. But he offered providers no hope for a bid submission reprieve. The deadline to submit bids still stands at 9 p.m. prevailing Eastern Time on July 20. (See HomeCare Monday Special Alert, July 10.)

Even as the clock winds down, attempts are still being made to modify or halt DMEPOS bidding.

While "all suppliers must operate under the assumption that the bidding deadline closes as announced," cautioned Walt Gorski, vice president of government affairs for the American Association for Homecare, he added that "we are seeking congressional help through [letters] to the CMS administrator requesting that certain fundamental questions be addressed before the implementation of competitive bidding."

Separate House and Senate letters from a bipartisan group of legislators point out that the 60-day bid window does not provide enough time for providers to get information about the details of bidding and to get their questions answered, Gorski said. Those questions relate to product categories and codes--which the letters say "are too broad and inconsistent to adequately describe products"--the compressed timeline to submit bids and calculation of the median price.

Signed by 14 senators and sent out late Friday, the Senate letter also says the short bid window particularly affects small suppliers that wish to participate in bidding networks because they "must develop new business organizations, implement untried computer systems and address a large number of unresolved policy issues, including potential violations of antitrust laws."

"Transitioning to competitive bidding is a significant and highly complex undertaking," according to the lawmakers. "While Congress instructed CMS to begin competitive bidding in 2007, we strongly believe that due to its direct impact on daily patient care, it must be implemented carefully and with significant attention to the effect on patients."

A similar letter from 52 members of the House was expected to be delivered today to acting CMS Administrator Leslie Norwalk, Gorski said. The letters were shepherded by Reps. Tom Allen, D-Maine, and Sam Johnson, R-Texas; and by Sens. Kent Conrad, D-N.C., and Pat Roberts, R-Kan.

The association and other industry stakeholders also continue to seek sponsors for legislative efforts including H.R. 1845, the Medicare Durable Medical Equipment Access Act of 2007, also known as the Tanner-Hobson bill; H.R. 621, the Home Oxygen Patient Protection Act (also known as the HOPP Act); S. 1428, the Senate companion bill to Tanner-Hobson; and H.R. 2231, the Medicare Access to Complex Rehabilitation and Assistive Technology Act of 2007.

In addition, Gorski said stakeholders are pushing for inclusion of the provisions of each bill in the Medicare packages that both the House and the Senate are currently drafting.

The Tanner-Hobson bill and its Senate companion would allow qualified providers who submitted bids below the allowable to continue to participate in Medicare; it would require a complete analysis of the impact of competitive bidding once it has been fully implemented in the first 10 cities; and it would prohibit expansion of the competitive bidding program or the application of the bid rates to non-bid areas unless specifically authorized by Congress.

The HOPP Act would rescind a provision in the Deficit Reduction Act of 2003 that gives ownership and responsibility for oxygen equipment to patients after 36 months of rental through Medicare.

H.R. 2231 would carve out complex rehab equipment and assistive technology from the competitive bidding program.

"We are at the initial stages of this process," Gorski said about appealing to congressional members to include the provisions. "There will be opportunities to influence the process as these issues work toward conclusion ... congressional action may start becoming more clear as the packages are developed later this week."

On yet another front, DME suppliers and beneficiaries who filed a lawsuit on June 12 seeking to prevent implementation of competitive bidding are awaiting a response from the government.

"The U.S. Attorney's Office has 60 days from the time the suit was filed to respond," said Jeffrey Baird, chairman of the Health Care Group at Brown & Fortunato, PC, Amarillo, Texas, which filed the suit. "Accordingly, we expect the U.S. Attorney's Office to file an answer to the suit in early to mid-August, although it is possible the government could respond any day now."