What's the score? Industry needs to stay focused

WASHINGTON - A huge variance in cost estimates for a proposal to expand the competitive bidding process to all areas of the country may be eye-catching, but industry stakeholders remain focused on the big picture.

The Congressional Budget Office estimates that the proposal, included in the president's fiscal 2019 budget, would cost $1.3 billion over 10 years; The Department of Health and Human Services says it would save $6.5 billion over the same time period, according to an article in Inside Health Policy.

“This happens all the time,” said Jay Witter, senior vice president of public policy for AAHomecare. “The CBO is bound to Congress and the OMB is bound to the administration. They do it differently and they don't communicate with each other.”

Under the proposal, CMS would expand the bid process to all non-bid areas, including rural areas. The agency would also pay contract providers using their actual bid prices, not the median bid prices.

The proposal, first announced in February, caught stakeholders off-guard, but they say, ultimately, they don't think it has legs.

“At this point, we don't believe there's a huge appetite for it (among lawmakers),” said Cara Bachenheimer, chair of the newly formed Government Affairs Practice, Brown & Fortunato. “It's our collective mission to make sure they maintain that lack of appetite.”

The industry's strongest arguments against expanding the bidding process come from CMS's own comments in the recently published interim final rule, where it acknowledged for the first time there are problems with the program.

“I think the IFR gave (us) tremendous credibility because lawmakers have been told for years and years that there are no problems and now finally the federal government has acknowledged the problems,” said Witter. “We'll use the rest of the year to build on that.”

Stakeholders will continue to push H.R. 4229, a bill that would provide broader relief from the bid program. It picked up an additional four co-sponsors last week following the AAHomecare Washington Legislative Conference, for a total of 149.

“We still want to push H.R. 4229 and we need to have a Senate bill,” said John Gallagher, vice president of government relations for VGM. “There's a realization that the can has been kicked down the road long enough and there needs to be a fix.”