NEXT ROUND OF COMPETITIVE BIDDING: COMMENT PERIOD CLOSES

VGM Group, the Council for Quality Respiratory Care and Cardinal Health at-Home Solutions have all shared the comments they submitted in response to CMS’s plans to resurrect the national competitive bidding program. The deadline for submitting comments was Friday, Aug. 29. 

Key recommendations in VGM’s comments include: 

• Opposing the proposed Remote Item Delivery Competitive Bid Program.  
• Urging CMS to exclude ostomy, urological and tracheostomy supplies from the bidding program.  
• Advocating against the inclusion of liquid oxygen, diabetes products, and OTS upper-extremity braces in the program. 
• Retaining the bid ceiling at the unadjusted 2015 fee schedule.  
• Preserving the current methodology for calculating the single payment amount (SPA) using the clearing price. 
• Opposing the proposed shift to determine SPAs for lead items based on the 75th percentile of winning bids. 

Key points made by Cardinal Health at-Home Solutions: 

• At-Home Solutions opposes the proposal to reclassify all CGMs and insulin infusion pumps under the FSS payment category and the proposal that CMS pay for all CGMs and insulin infusion pumps on a monthly rental basis under both the DMEPOS CBP and in non-competitive bidding areas through the fee schedule payments. 
• The proposed changes to regulations at subpart C of 42 C.F.R 414 are not necessary for the effective implementation of the DMEPOS CBP mandated by section 1847(a) of the Social Security Act. 
• CMS is soliciting comments on a proposal that would evaluate the fee schedule for CGM products and insulin infusion pumps not based on its inherent reasonableness authority, under 42 CFR 405.502, but based on payment information determined under the CBP for the rental of the equipment using the methodology established in regulations at 42 CFR 414.21(g). 
• CMS’s proposal to expand the circumstances in which the agency may revoke or deactivate a supplier’s billing privileges and apply retroactive revocation poses significant penalties on suppliers without reasonable notification or due process and are not necessary to prevent fraud and abuse. 
• CMS is correctly proposing to exempt a DMEPOS supplier’s parent company that is undergoing an internal corporate restructuring from additional enrollment and survey requirements, but CMS should expand its proposal to clarify that “parent” under this rule would include any entity that is a direct or indirect owner of the DMEPOS supplier. 

Key recommendations in the CQRC’s comments include: 

• Given concerns with the untested proposed 75th percentile methodology and changes to financial documentation requirements for the Medicare CBP, the CQRC would like to work with the Trump Administration to ensure that future CBP rounds address problems with the Round 2021 lead-item methodology and protect patient access to prescribed DMEPOS equipment, supplies and services. 
• The 75th percentile methodology does not reflect market-based pricing, jeopardizes patient access to physician-prescribed devices, and makes it easier for fraudulent entities, especially foreign actors, to conduct DMEPOS scams. We offer to work with CMS to consider and test other policy options in a smaller pilot program before implementing a new CBP round. 
• If CMS were to move forward with a new round of CBP in the near future, CMS should remove supplemental oxygen from future rounds to lock in savings already achieved and support legislative reforms to restore access to liquid oxygen and respiratory therapy services. 
• CQRC supports reducing fraud and abuse and urges CMS to adopt more effective policies than the proposed annual accreditation surveys.