N.C. providers make progress against CB

RALEIGH, N.C. — It looks like North Carolina providers may have dodged the Medicaid competitive bidding bullet for the second time, but they're not getting off scot-free. North Carolina had considered competitive bidding to help close an $800 million budget deficit. But state providers embarked on an aggressive lobbying campaign that convinced key lawmakers and Medicaid officials that the necessary savings ($1.6 million) could be achieved by a 3%-4% across-the-board cut to the fee schedule. "We took a strong look at the fee schedule and determined that there is nothing there that can't take a hit," said Clark Robichaux, v.p. of North Carolina Association for Medical Equipment Services (NCAMES). By adopting a fee-schedule cut rather than competitive bidding, the state achieves the necessary savings, and doesn't implement a new, untested reimbursement methodology that could drive providers out of business and decrease beneficiary access, Robichaux said. Medicaid competitive bidding is not new to NCAMES. In 1997, the association turned back a proposal for competitive bidding by sitting down with state officials and making adjustments to the fee schedule that saved North Carolina about $1 million. Members of the N.C. House of Representatives and Senate still have to craft final budget language, but with the support of Medicaid officials, it looks like competitive bidding is dead for the time being, Robichaux said. Providers have also suggested that N.C. Medicaid use Medicare's stricter criteria for qualifying home oxygen patients. Doing so would save the state an additional $150,000, Robichaux said. "We want to let them know that we are looking for long- range fixes to the system, and if we see problems from a provider's standpoint than we want to help them out," he said. HME