WASHINGTON--While a bill introduced Thursday in the House of Representatives calls for a moratorium on the implementation of the competitive bidding program, it would also make improvements to the bidding process and establish quality measures along with other improvements, according to Cara Bachenheimer, senior vice president of government relations for Invacare, Elyria, Ohio.

The bottom line, she said, is an 18- to 24-month delay of round one, and round two could not occur before January 2011.

The “pay for” would be a 9.5 percent reduction in 2009 for items that CMS included in round one. A CPI update would then resume in 2010 for these same items as well as all other DMEPOS items. Items not included in round one (e.g., manual wheelchairs) would not be cut in 2009 and would receive a full update in 2009.

Bachenheimer offered the following bullet-point summary of H.R. 6252, the Medicare DMEPOS Competitive Acquisition Program Reform Act of 2008:

Delay of rounds one and two of the bidding program:

• Terminate contracts under round one and rebid so that new contracts would take effect in 18 to 24 months.
• Round two contracts cannot take effect before January 2011.
• Payment adjustments in non-bid areas may not take effect until round two is completed.

Offset to pay for the delay:

• In 2009, eliminate the annual payment update (CPI) and reduce payments by 9.5 percent nationwide for those items subject to competitive bidding in round one. All other items would receive the CPI update.
• In 2010 through 2013, all items would receive CPI update.
• In 2014, items that had been subject to the 9.5 percent reduction would receive an additional 2 percent update over the CPI except in areas where competitive bidding contracts are already in place.

Bidding process improvements:

• Require CMS to notify bidders of paperwork discrepancies and give opportunity to correct within a reasonable time frame.
• Provide CMS with the authority to subdivide MSAs with 8 million or more in population.
• Exempt rural areas and MSAs with a population of 250,000 or less from competitive bidding for at least five years.
• Require that suppliers who bid on diabetic testing supplies offer brands that cover at least 50 percent of the market by volume (does not apply to round one).
• Before using its authority to adjust prices in non-bid areas, CMS must issue a regulation and consider how prices set through competitive bidding compare to costs for such items in non-bid areas.
• Require HHS’ Office of Inspector General to verify calculations used to determine the pivotal bid amount and winning bid amounts.