Tomorrow's edition of the Federal Register will include an interim final rule for competitive bidding, according to a notice from the American Association for Homecare.

The rule includes a rebid of Round One in 2009 and details regulatory requirements related to changes made to the DMEPOS bidding program by the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA). Passed in July, MIPPA delayed the bidding program.

According to the rule document:

"Specifically, this rule: implements certain MIPPA provisions that delay implementation of Round 1 of the program; requires CMS to conduct a second Round 1 competition (the "Round 1 rebid") in 2009; and mandates certain changes for both the Round 1 rebid and subsequent rounds of the program, including a process for providing feedback to suppliers regarding missing financial documentation and requiring contractors to disclose to CMS information regarding subcontracting relationships."

The rule will take effect 30 days after its Jan. 16 publication — on Feb. 15. CMS will take comments during a 60-day comment period ending March 17.

The Round One rebid does not include negative pressure wound therapy, and MIPPA permanently excludes group three power rehab wheelchairs from competitive bidding.

The rebid also drops San Juan, Puerto Rico, one of the original 10 MSAs chosen by CMS in which to begin the bidding program. The other nine remain on the list:

• Cincinnati-Middletown (parts of Ohio, Kentucky, Indiana)
• Cleveland-Eyria, Ohio
• Charlotte-Gastonia-Concord (North Carolina and parts of South Carolina)
• Dallas-Ft. Worth, Texas
• Kansas City, Missouri (and parts of Kansas)
• Miami-Ft. Lauderdale-Miami Beach, Florida
• Orlando, Florida
• Pittsburgh, Pennsylvania
• Riverside-San Bernardino, California

CMS will notify HME providers if their bid submission is missing any of the required financial documents and will allow them to submit missing documents within 10 business days of the notice.

"It's unfortunate that this rule will be released literally in the final hours of the Bush administration," said Tyler Wilson, AAHomecare president. "The fundamental problems associated with the bidding remain — this program will [actually reduce] competition, reduce access to care for seniors, reduce patient choice, reduce quality and put good providers out of business."

Because it is an interim final rule, Wilson said, CMS can re-launch the bidding program quickly without any "meaningful" opportunity for public comment or input.

"CMS should have allowed for a discussion of the problems encountered during Round One of the bidding process," Wilson said. "A proposed rule rather than an interim final rule would have allowed for greater public discussion that is sorely needed on a program of this magnitude.