The GWU study notes that in contrast to the standards in Medicare Part
D and in Medicare Advantage, the competitive bidding program lacks rigorous
standards for quality and safety, but instead is focused on price
discounts. For example:
-- The only required contracting standards are that amounts paid to winning
entities be expected to be "less than the (current fee
schedule)" and that individuals have a "choice of multiple
suppliers." There are no evidence-based standards for the types of
products being offered.
-- The law setting up the program does require that winning contractors
meet "applicable quality standards." CMS regulations do have
quality standards for the program, but those standards lack specific
marketing guidelines that would require approval of materials before
entry into the marketplace, much like CMS imposes on Part D plans. Among
the patient-focused standards CMS should insist suppliers meet ought to
include materials that meet basic readability standards and toll-free
telephone hotlines with Spanish-speaking options.
The GWU study notes that CMS has not engaged in a major campaign to educate beneficiaries about the changes. "It is unclear how beneficiaries would learn to navigate the market to obtain daily products; indeed, it appears that they are simply expected to respond to aggressive marketing by online firms or through cold calls, precisely the type of aggressive marketing approaches that have raised concerns in other markets," the study says.
The GWU study also noted that when Medicare conducted a demonstration
program from 1999-2002 to study competitive bidding, diabetes equipment and
supplies were not includ
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