New durable medical equipment bidding process ill suited to long-term care, Congress told

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Structural flaws in the newly implemented durable medical equipment competitive bidding process have caused significant service interruptions and supply problems for residents in long-term care facilities, congressional staff heard at a briefing Tuesday.

A group of DME suppliers joined patient advocacy groups on Capitol Hill to offer their critique of the competitive bidding program, which took effect Jan. 1. Patients in long-term care facilities are especially affected by the new program, according to Cynthia Morton, Executive Vice President of the National Association for the Support of Long Term Care.

“Competitive bidding was designed for beneficiaries who are mobile and not institutionalized, and it fails to address the numerous challenges that it has created for long-term care facilities,” she said. “It appears that some of the aspects of the competitive bidding program are based more on math than on good policy.”

Under the competitive bidding program, those seeking DME supplies can purchase them only from companies that submit the lowest bid to, and are approved by, the Centers for Medicare & Medicaid Services. But according to some of the statements delivered at the briefing, DME suppliers often submit low bids in order to gain access to a certain market and then drop out of the process. The prices set by these “drive-by bidders,” as Morton calls them, then influence the prices CMS pays to other suppliers.

Nine metropolitan areas have implemented the DMEPOS competitive bidding program since Jan. 1; it is set to add at least 90 more metro areas, including New York City, Los Angeles and Chicago, by the end of the year. The congressional briefing was sponsored by Reps. Glenn Thompson (R-PA) and Jason Altmire (D-PA) and was intended to introduce new legislators to the controversial program.

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