Round 2019 improves process, but providers wait and see

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Friday, March 10, 2017

YARMOUTH, Maine – With Round 2019 of the competitive bidding program on hold indefinitely, providers like Woody O’Neal say they’re holding off doing any prep work for submitting bids, when and if it goes forward.

“I don’t think we will even spend any man hours on it until something official is announced, said O’Neal, vice president of O2 Neal Medical in Pelham, Ala. “It could change significantly or not happen at all, and I’d rather not spend staff time on it at this point.”

When and if Round 2019 does go forward, CMS has implemented several changes that could vastly improve the program, providers say.

For provider Steve Ackerman, a new requirement that bidders obtain a $50,000 surety bond for each CBA in which they submit bids will force the hand of providers to really assess whether or not they can actually service a contract for what they bid.

“First of all they are going to be assessed by the insurance company as to whether or not they can actually deliver services,” said Ackerman, owner of Spectrum Medical in Silver Spring, Md.“Nobody will take a chance on losing a bond with speculative bidding. The lesson in this round is, you are in the game or you are not.”

The flip side of requiring surety bonds is it could prevent smaller companies from bidding, says provider Chris Rice.

“For smaller providers that are operating in multiple areas, you now have to show X many dollars of equity to be able to get those bonds,” said Rice, the CEO of Diamond Respiratory in Riverside, Calif.

Providers also have their fingers crossed that the downward spiral in pricing may finally be stopped. In a sign that even CMS knows the bid rates have become unsustainable, the agency has moved the bid ceiling to 2015 fee schedule amounts.

Still, “we might see a bit of a bump there, but I don’t think we are going to see a profound change reimbursement wise,” said Rice.

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