"We are hoping that the bill will be passed and that we can get a Senate companion bill, and we won't have to go through this program," Brant commented. Because, unfortunately, it became obvious that Medicare was looking at the company that could put the lowest number on a sheet of paper, but not actually if the company could stay in business, and provide services and equipment to patients. And that was a real problem."

In addition to the 18-month delay, MIPPA also imposed a 9.5% cut on the industry in order to take that delay. The Centers for Medicare and Medicaid Services (CMS) also found 63% of the providers were disqualified. If documentation required for the bid was missing, CMS would notify the provider 30 days prior to the deadline. That document review date just ended on November 21, 2009. However, Brant pointed out, these were the only changes through MIPPA. "You still don't have to have a physical location in or near the bidding area. You can still sell your business. And Medicare is still not going to evaluate whether the company can stay in business with any local bids sent in."


CMS has presented the DMEPOS bidding as an anti-fraud measure. In November, DOTmed reported on testimony from the Senate Judiciary Committee on Health Care Fraud. In those hearings, Deputy Secretary of the Department of Health and Human Services, Bill Corr, stated that that DMEPOS has particular risk for fraud. He also said HHS is employing new methods of analysis in using claims data to identify fraud and implementing new prevention techniques. Much of the focus is on suspicious spikes in DME claims. (See, DM 10690)

Brant says that in fact there is a disconnect between actual anti-fraud measures in the industry and the DMEPOS bidding. "The truth of the matter is that there has been a [recent] reduction of about 50 percent of the oxygen providers in many metropolitan areas. Miami is one of them. In Miami Dade County there were 401 oxygen providers in 2008. In October 2008 there was a mandatory requirement of accreditation and a minimum $50,000 surety bond. Those two requirements caused a 50 percent drop in providers. In addition, because of greater oversight, there was a 36-month payment cap in oxygen which began in January 2009 [in addition to the 9.5% cut]."

AMEPA wholeheartedly supports the surety bond and the mandatory accreditation. Brant says, "My own company, City Medical Services, has been in business since 1997 and I have been accredited by the Joint commission since 2000--back when it was just voluntary."

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