CMS: A master at market manipulation?

I admit I'm not one for change.

But earlier this week, when I read CMS's release outlining some of the details for the Round 1 “recompete,” I bristled more than usual.

I expected, silly me, a re-do of the Round 1 re-bid, which was essentially a re-do of the original Round 1, with a few minor changes like dropping Puerto Rico as a bid area and limiting bids for support surfaces to the Miami bid area.

Those are changes I can deal with.

And I guess CMS made at least one significant change to Round 2 when it decided to combine manual and power wheelchairs into one product category. At least, I feel, the industry saw that one coming.

But the Round 1 “re-compete”? We have six instead of nine product categories, and few of these categories are comprised of the same products as the original Round 1, the Round 1 re-bid, or Round 2 for that matter.

Combining oxygen and sleep equipment and supplies into one product category?

Adding TENS to the general HME product category?

Introducing a new product category altogether: infusion pumps and supplies?

Let's consider TENS. First of all, isn't CMS considering dropping coverage for TENS for chronic lower back pain because, presumably, it believes the benefit is misused and/or overused? Then why would the agency include it in competitive bidding? Is this, as one provider theorized recently, CMS's stab at preserving the benefit?

Secondly, not many providers supply TENS that I know of, but many providers supply beds. In the Round 1 “recompete,” they must supply both to bid?

Never mind that CMS has included in competitive bidding unfair practices like non-binding bids and a median pricing mechanism.

Now the agency is, in effect, dictating what providers supply?

They're also, in effect, dictating their size, as only large providers have the financial resources and wherewithal to add products based on a whim like this.

It's always been the word on the street that with competitive bidding CMS is trying to manipulate more than price.

Well, this pretty much proves it.