BALTIMORE--After several weeks of intense pressure from legislators and months of lobbying by industry stakeholders, on Friday CMS extended its first-round window for DMEPOS competitive bidding by 60 days. (See HomeCare Monday Special Alert, July 27.)

The deadline for providers to submit bids--which had been set for 9 p.m. Friday--was extended to Sept. 25. It's the agency's third deadline extension in as many weeks, though the other two--the first to July 20 and the second to July 27--were only for a week each.

The deadline for bid registration has been pushed to Aug. 27, and the accreditation deadline for suppliers to be considered for contracts is now Oct. 31.

The latest extensions follow a concentrated lobbying effort by the industry that culminated in a letter from Senate Finance Committee officials to CMS requesting an extension of 90 days. In the July 20 letter, committee Chairman Max Baucus, D-Mont., and Ranking Member Charles Grassley, R-Iowa, said they had "serious concerns" about problems with CMS' online bidding system and asked the agency to respond by July 25.

On that day, during a confirmation hearing for CMS Administrator nominee Kerry Weems, committee members made several requests for the extension, citing providers' difficulties in bidding. Sen. Pat Roberts, R-Kan., wrapped up the hearing with a 20-minute laundry list of providers' specific bidding problems compiled by the Midwest Association of Medical Equipment Services, buying groups VGM and The MED Group and other industry associations and stakeholders from throughout the country.

Roberts read the examples of problems into the hearing record, including numerous technical difficulties and other issues with the bidding system itself, bid instructions and lack of details about the program, product category issues and changes to the process.

As part of the lobbying effort, providers were encouraged to print out actual error messages from the bidding system, which made a convincing case with legislators, according to John Gallagher, vice president, government relations, for VGM. While CMS had indicated problems with the system had been resolved, Gallagher said, when "the print screens show errors from their own system, then it's hard for them to dispute it."

On Thursday afternoon, MAMES said it had learned that as a result of the bidding issues aired during the hearing, CMS planned to announce the extension.

According to MAMES Executive Director Rose Schafhauser, a 90-day extension would have been preferable, but "you take whatever you can get at this juncture."

Since registration for bidding opened April 9, providers have reported trouble getting user IDs and passwords, not getting adequate guidance--or the wrong guidance--on questions and being shut out of the Internet-based bidding system. Such difficulties prompted MAMES to enlist the aid of Sen. Roberts, Schafhauser said.

"Our whole push through the senator's office was trying to get this thing delayed and trying to get [CMS] to understand all the issues that providers are facing," Schafhauser said.

She and representatives from Roberts' office met with CMS officials in late May about incorrect information being dispensed through the Competitive Bidding Implementation Contractor helpline. Schafhauser said she pointed out that "the people who are on the front lines don't have the knowledge [CMS policymakers do] ... What if providers are taking what these people are saying verbatim?" (See HomeCare Monday, June 11.)

Schafhauser added that she hopes CMS will use the extra time "not just to pacify folks" but to fix problems with the system and answer bidders' remaining questions.

In response to CMS' first bid extension, the American Association for Homecare joined several other stakeholder groups to go after support in Congress for a longer delay in implementation of the bidding program. Fourteen senators and 65 representatives signed letters to CMS calling for a slowdown.

Even with the bid extension, however, the association urged providers to continue to work toward completing their bids, noting that "since there is no certainty that problems faced by HME providers will be addressed during the next 60 days," they should redouble efforts for congressional action on H.R. 1845, the Tanner-Hobson bill, and its Senate companion, H.R. 1428. The bills address "many of the shortcomings with the Medicare competitive bidding system," AAHomecare said.

While CMS has not released the number of providers who have registered in the first 10 bidding areas, founder Chris Rice of provider forum competingbid.com noted a recent post from a provider who signed up to bid at the last minute (before the previous registration deadline of June 30) and was given a bidder identification number in the 900s.

"Assuming that's a sequential number, there are far fewer bidders than expected," Rice said. "However, it is probably enough for the CBIC to work with."

To view CMS' bid extension notice in full, click here.

For a replay of Weems' confirmation hearing, go to finance.senate.gov, click on "Hearings," then select 7/25/07.

For information on H.R. 1845 and S. 1428, visit the AAHomecare Web site at www.aahomecare.org.