Competitive Bidding and MPP Webinar
The following announcement is from CMS via www.dmecompetitivebid.com
TIMELINE
The Centers for Medicare & Medicaid Services (CMS) announces bidding timeline, begins bidder education program
11/30/2011 The Centers for Medicare & Medicaid Services (CMS) announces bidding timeline, begins bidder education program
12/5/2011* Registration for user IDs and passwords begins
12/22/2011* Authorized Officials are strongly encouraged to register no later than this date
1/12/2012* Backup Authorized Officials are strongly encouraged to register no later than this date
1/30/2012* CMS opens 60-day bid window for Round 2 and National Mail-Order Competitions
2/9/2012* Registration closes
2/29/2012* Covered Document Review Date for bidders to submit financial documents
3/30/2012* 60-day bid window closes
Fall 2012* CMS announces single payment amounts, begins contracting process
Spring 2013* CMS announces contract suppliers, begins contract supplier education campaign
Spring 2013* CMS begins supplier, referral agent, and beneficiary education campaign
July 1, 2013* Implementation of Medicare DMEPOS Competitive Bidding Program Round 2 and National Mail-Order Competition contracts and prices
MEDICARE EXPANDING COMPETITIVE BIDDING PROGRAM TO SAVE BILLIONS
PROGRAM EXPANDED BY AFFORDABLE CARE ACT
Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Competitive Bidding Program
AAHomecare Continues Fight for Market Pricing Program after Deficit Committee Collapse
As earlier reported, last week the 12-member Joint Select Committee on Deficit Reduction, known as the Super Committee, failed to agree on a plan to reduce the deficit by at least $1.2 trillion. The failure to reach an agreement means that there will be an automatic sequestration of government spending – budget cuts – to achieve the $1.2 trillion in savings. The Congressional Budget Office released an estimate that the across-the-board cuts for Medicare will be translated into a two percent decrease in payment to providers in 2013.
AAHomecare had been working with Super Committee members, as well as House and Senate leadership, to include the Market Pricing Program (MPP) in the final recommendations of the committee. MPP would change the flawed “competitive” bidding program to a sustainable market based pricing system for HME items in Medicare, which would protect HME providers and patients. Review the MPP summary here.
Despite the failure of the super committee, AAHomecare continues to work with Congress to pass MPP into law at the earliest legislative opportunity.
While AAHomecare has received positive feedback from the Hill regarding MPP, the effort to stop the bidding program has not been easy. The Administration opposes any changes to the current bid program and continues to tout its “success.” HME providers need to continue their efforts to educate federal legislators on the flaws of the current bidding program and the urgent need to stop it.
It is vital that you contact your Representative and your Senators’ offices and tell them:
Medicare’s bidding program for HME is fatally flawed. More than 30 patient advocacy groups, 244 economists and auction experts, and 165 members of Congress oppose this program.
Once again, CMS has chosen to ignore Congress’ directive to address significant problems with the bid program.
The bidding program will cause beneficiaries to spend more time in expensive institutions, rather than in the far more cost-effective setting for care – their own homes.
Round 2 of competitive bidding has already begun, so Congress must stop the bidding program at the earliest legislative opportunity.
You can reach your Representative and Senators’ office by calling the Capitol switchboard at 202-224-3121. If you have any questions or feedback from your legislators’ staff, please contact Jay Witter at jayw@aahomecare.org.
Medicare contractors are increasing their audit activity, responding to added pressure from the recent CMS announcement that the 2011 Medicare error rate for HME is 61 percent.
Reducing the number of unnecessary audits is a top priority of AAHomecare. The Association continues to work with Centers for Medicare and Medicaid Services (CMS) staff and the DME MACs to ease the burden of audits on providers and to establish consistency in the audit process and requests for additional documentation. The Association has asked that the DME MACs focus on auditing more recent claims, with an initial date of service within the last few months, rather than claims that would require documentation from several years ago. And if audits do focus on old claims, AAHomecare has suggested that the DME MACs increase the 30-day response timeframe to allow sufficient time for doctors and hospitals to gather the necessary documentation.
Given the Obama Administration’s directive for all agencies to cut their error rates in half by 2012, the DME MAC prepayment audits are likely to continue for the foreseeable future.
One reason why HME error rates remain so high is providers who do not respond to an audit or submit any requested documentation. As many as 50 percent of denials resulted because the provider did not respond, according to DME MAC prepayment audit results.
Therefore, AAHomecare urges all HME providers to respond to EVERY additional documentation audit request – even if it concerns a low dollar amount – to help reduce the error rate. Drastic reductions in the error rates may go a long way toward reducing the burden of audits on providers in the future and reduce the strain that audits have on running your HME.
