The PAOC Blues

It sounded like a good idea at the time. In 2003, one independent pharmacist, yours truly, was selected as one of 20 DMEPOS industry stakeholders to become a member of the CMS Program Advisory and Oversight Committee (PAOC).

Mandated in Section 302 of the MMA, the goals of the PAOC are to provide advice on the following:

1. The implementation of the Competitive Acquisition Program (CAP) (competitive bidding).
2. The establishment of financial standards that take into account the needs of small providers. The establishment of requirements for collection of data for the efficient management of the program.
3. The development of proposals for efficient interaction among manufacturers, providers of services, suppliers, and individuals.
4. The establishment of quality standards.

The problem is that while the committee can propose changes in the development and implementation of the program, CMS is under NO obligation to accept the recommendations.

To be fair, some of our recommendations have been adopted, such as not starting the program in the largest MSAs like New York, Chicago, or Los Angeles in the first round in 2007.

However, in other instances, PAOC recommendations have not been accepted. A case in point was the committee's unilaterally strong objections to the proposed DMEPOS rebate program, which would allow suppliers submitting a bid below the single payment amount to provide a rebate to the beneficiary. Fraught with disturbing accountability fears and disquieting fraud concerns, this program is still on the table.

Regretfully, the PAOC has “no teeth.”

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