Independence from the worries of competitive bidding will have to wait as CMS marched on with its July 1 implementation of round one. “Already the problems are flying and we are only 4 hours into the day,” wrote Wayne Stanfield, president of the National Association of Independent Medical Equipment Suppliers (NAIMES) in a July 1 message to members. “NAIMES has received numerous reports of problems with the bidding process this morning.”

Industry activists point to the sheer complexity of the Medicare package as a major barrier to its timely passage. At more than 200 pages, there were simply too many provisions to agree on. The good news for providers is that the fight is not over. “Between the 8th and the 12th [of July], this Senate bill will be voted on,” said Rob Brant (pictured, left), president of the Accredited Medical Equipment Providers of America, Miami. “There is no conflict with home medical equipment. We have a zero cost to the government for an 18-month delay. The issue is the Medicare Advantage plan.”

AAHomecare officials also assured members this week that the Senate will debate the Medicare package again after the July 4 recess. On June 30, just prior to the July 1 implementation date, AAHomecare tried to obtain an administrative delay that would have allowed Congress to complete action on the Medicare legislation, which includes important reforms to the bidding program. However, CMS ultimately declined the administrative delay and began the bidding program as scheduled.

In a June 26 vote a week ago, Senate proponents of the House-passed Medicare package that included the “doc fix,” failed to get the 60 votes needed to end debate and move to a vote. HR 6331, the Medicare Improvements for Patients and Providers Act of 2008, includes provisions to reform the competitive bidding program, which were endorsed by AAHomecare. The provision to delay competitive bidding calls for a 9.5% payment cut to home care items and services subject to bidding. AAHomecare is urging providers to continue calling Senate district offices in support of HR 6331 while the push for reform/delay has momentum.

To ensure that the inevitable problems are well documented, AAHomecare has set up a special Web page form to collect all complaints. Providers can also point patients to a separate web form designed specifically for beneficiaries who wish to document complaints. The VGM Group is also collecting provider problems encountered in week one of competitive bidding.

The following metropolitan statistical areas (MSAs) are now officially subject to competitive bidding contracts and fee schedules:
• Charlotte-Gastonia-Concord, NC-SC;
• Cincinnati-Middletown, OH-KY-IN;
• Cleveland-Elyria-Mentor, OH;
• Dallas-Fort Worth-Arlington, TX;
• Kansas City, MO-KS;
• Miami-Fort Lauderdale-Miami Beach, FL;
• Orlando, FL;
• Pittsburgh, PA;
• Riverside-San Bernardino-Ontario, CA; and
• San Juan-Caguas-Guaynabo, Puerto Rico.