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Homecare Provider Testifies on Downside of Medicare 'Competitive' Bidding Program Before House Energy and Commerce Subcommittee
Date:9/15/2010

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Let me speak to the issue of transparency. 136 members of Congress believe that CMS has not shared enough information about the program.  Transparency is intended to protect the public. The lack of transparency masks deficiencies in the program and makes it impossible to evaluate fully the way CMS reached its various decisions at every stage of the process.  CMS' unwillingness to share even the most basic information about the program raises serious questions. From an administration that touts its openness and transparency, we have seen none with this program.

Savings Are Questionable

Let me turn to projected savings that are supposed to come from bidding. The extraordinarily low bid rates will be unsustainable over a three-year contracting period.  The argument that the prices determined through the bidding process are indicative of "true" market pricing is completely unfounded.  The bid system established skewed incentives, resulting in prices that reflect a desperate need to preserve their business and ability to serve people. In the most recent round of bidding, a power wheelchair provider submitted a low bid, was offered a contract but had no intention of accepting the contract.  CMS did not adjust the payment rate to reflect this.

Not an Anti-fraud Tool

On the question of fraud prevention, first let me say that home medical equipment providers have no tolerance for fraud. But arbitrarily limiting the number of legitimate providers in the marketplace will do nothing to stop those whose only intent is to defraud the Medicare program.  CMS must do a better job of monitoring claims and the billing credentials given to those who would scam the system.  The HME community should not be penalized when CMS grants Medicare billing credentials to a Post Office box or to an empty closet. The government is simply not doing an adequate job of site inspections bef
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SOURCE American Association for Homecare
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