OIG to Investigate Bidding Program

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) has announced plans to investigate the controversial Medicare bidding program to “determine whether CMS selected DMEPOS suppliers and computed the single payment amounts in accordance with Federal requirements.” The request for an investigation came from Representatives Glenn Thompson (R-Pa.) and Bruce Braley (D-Iowa) because of their grave concerns about state licensure issues with some providers who were awarded contracts in Round 2. Specifically, the Representatives asked OIG to investigate problems in Maryland, Michigan, Ohio, and Tennessee. These same states were included in AAHomecare’s lawsuit against HHS

“As a provider in New York, I’ve been embroiled in the bidding program mess for years, and I’ve seen for myself the disruptions in patient care, the business failures, and CMS’ inability to abide by their own rules,” said incoming president and CEO of AAHomecare, Tom Ryan. “But I’ve also seen how the HME industry is pulling together to fix these problems. This investigation is a result of providers contacting their representatives in Congress and educating them about how CMS mismanagement is hurting both patients and businesses. If enough providers speak with one voice through AAHomecare, we can’t be ignored.”

In his letter to Thompson and Braley, the Inspector General states:

“OIG believes that it’s important that DMEPOS companies meet state licensure and accreditation requirements, and therefore we have decided to conduct a limited scope review in the four states you have indentified (TN, MD, MI, OH) to address your concerns related to licensure and accreditation. We will determine how CMS applied state licensing requirements under Round 2 of the competitive bidding program in these states to suppliers that were awarded contracts. We will also determine the impact on the single payment amounts as well as the program in the affected competitive bidding areas.”

“OIG’s investigation is an important development, which will validate AAHomecare’s concerns with the Round 2 process. The result will be further proof that Congress needs to stop Round 2 and pass legislation that would implement the market pricing program,” said Robert Steedley, president of Barnes Healthcare and chairman of AAHomecare’s Board of Directors. “The Association is grateful for Representatives Thompson and Braley’s continued efforts to protect patients’ access to homecare.”

Jay Witter, vice president of government affairs at AAHomecare, added, “This investigation will help refute CMS’ claim that the Round 2 process is running smoothly. We are confident that OIG will undercover the same information we found when filing the lawsuit against HHS.”

The report is expected later this year.

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