Moving the HME Industry Forward

Legislative/Advocacy

Braley and Thompson Spark OIG Investigation of Competitive Bidding

September 2, 2013

WASHINGTON, DC – Responding to a request from Reps Glenn Thompson (R-Pa) and Bruce Braley (D-Iowa), the Department of Health and Human Services (HHS) Office of Inspector General (OIG) has announced plans to investigate the Medicare competitive bidding program.

The stated mission is to “determine whether CMS selected DMEPOS suppliers and computed the single payment amounts in accordance with Federal requirements.” The OIG will specifically investigate problems in Maryland, Michigan, Ohio, and Tennessee, the same states included in AAHomecare’s lawsuit against HHS.

“As a provider in New York, I’ve been embroiled in the bidding program mess for years, and I’ve seen for myself the disruptions in patient care, the business failures, and CMS’ inability to abide by their own rules,” said Tom Ryan (pictured), incoming president and CEO of AAHomecare. “But I’ve also seen how the HME industry is pulling together to fix these problems. This investigation is a result of providers contacting their representatives in Congress and educating them about how CMS mismanagement is hurting both patients and businesses. If enough providers speak with one voice through AAHomecare, we can’t be ignored.”

In a letter to Thompson and Braley, the Inspector General states:
“OIG believes that it’s important that DMEPOS companies meet state licensure and accreditation requirements, and therefore we have decided to conduct a limited scope review in the four states you have indentified (TN, MD, MI, OH) to address your concerns related to licensure and accreditation. We will determine how CMS applied state licensing requirements under Round 2 of the competitive bidding program in these states to suppliers that were awarded contracts. We will also determine the impact on the single payment amounts as well as the program in the affected competitive bidding areas.”

Regardless of what the OIG determines, Jeff Baird, JD, believes any halt to competitive bidding will ultimately have to come from legislators. “The DME industry will not get any relief on competitive bidding from CMS,” said Baird, chairman of the Health Care Group at Brown & Fortunato. “The only relief the industry will get will be from Capitol Hill…Having the OIG step in and conduct a limited investigation is a positive. This tells Capitol Hill that it is not just the industry that is concerned. The government itself—the OIG—also has concerns. I see this as one more step in convincing Congress to replace competitive bidding with the market pricing program.”

Georgie Blackburn, vice president, Government Relations and Legislative Affairs, BLACKBURN’S, added, “The OIG investigation is important because it begins to peel the banana…It’s a good first step at the right time as our industry pushes for resolve.”