Winning suppliers must be careful not to provide DMEPOS items at a loss to Medicare beneficiaries. Under the median price methodology, half of the “winning” bidders will be paid for DMEPOS at a rate below what they bid. The other half will have their bids RAISED to the median. So, if your bid was as low as you could go and you are a winning bidder above the median bid, your bid will be lower -- potentially below your costs. The final rule on competitive bidding doesn’t say whether those providers can withdraw from the program.
Accordingly, for this reason and others, a group of senators and representatives this week plans to send CMS two letters signed by more than a dozen of their colleagues urging the agency to delay national competitive bidding, but I would not hold my breathe. Sens. Pat Roberts, R-Kan., and Kent Conrad, D-N.D., and Reps. Tom Allen, D-Maine, and Sam Johnson, R-Texas, crafted the sign-on letters, which ask CMS to address several issues before closing the bidding window and implementing the program.
Bill Popomaronis, R.Ph., NCPA vice president, home health and long term care pharmacy services, provides his thoughts and explanations on the latest DME information from CMS.
