Help stop competitive bidding.
Competitive bidding, as it is structured now, has the potential to affect users of home mechanical ventilation. It is an attempt by the Centers for Medicare and Medicaid Services (CMS) to control Medicare expenditures for durable medical equipment, including bilevel units aka respiratory assist devices (RADs).
What is competitive bidding? CMS holds a competition among homecare providers of certain durable medical equipment in areas around the country. According to CMS, the Medicare providers who offer the best price, whom the agency decides can meet beneficiary demand and meet applicable quality and financial standards, is given a contract with CMS for a three-year period. The winning suppliers must agree to accept assignment on all claims for bid items and will be paid the bid price amount- the median of all winning bids for an item.
CMS press releases and fact sheets released this month (July) state that Medicare will pay for the 9 product categories* included in the first round of bids an average of 32 percent less than Medicare's previous payment amounts. Companies must bid low to win the bid, and according to the rules, all companies must accept that payment. The home care sector is concerned that many companies will not be able to stay in business or will have to cut services.
However, CMS stands by its processes and decisions at the moment and plans to implement the new payment system in these areas January 1, 2011. See www.cms.gov/dmeposcompetitivebid/
At the urging of the home care companies and many organizations who serve people with disabilities, Congressman Kendrick Meek (D-Fla.) introduced a budget-neutral bill (H.R. 3790) to repeal the controversial and deeply flawed program.
To learn more about the details and consequences of competitive bidding for people who use bilevel devices and their home health care suppliers, go to AAHomecare's Competitive Bidding Page.
* Oxygen, Oxygen Equipment, and Supplies; Standard Power Wheelchairs, Scooters, and Related Accessories; Complex Rehabilitative Power Wheelchairs and Related Accessories (Group 2 only); Mail-Order Diabetic Supplies: Enteral Nutrients, Equipment and Supplies; Continuous Positive Airway Pressure (CPAP) Devices, Respiratory Assist Devices (RADs), and Related Supplies and Accessories; Hospital Beds and Related Accessories; Walkers and Related Accessories; Support Surfaces (Group 2 mattresses and overlays in Miami-Ft.-Lauderdale-Pompano Beach, FL only).