Anyone familiar with Medicare will have already heard an earful about "Competitive Bidding." Its something they've been talking about for several years now. Until yesterday it was all just a lot of talk that didn't really seem to be of much concern to us here at Allcare. Pretty much every conference or education seminar that I've attended in the past 3 or 4 years has devoted at least a portion of their program to "Competitive Bidding" -- what it is; how it will impact you; how to prepare for it; how to stop it. I had heard the chatter and the controversy surrounding this topic for so long that I just kind of assumed it would go the way of ICD-10 and PECOS and all those other looming threats that have been hovering around our industry for years, with implementation dates that are repeatedly and predictably pushed back over and over again. Much to my surprise, despite the DME industry's best efforts, Medicare's Competitive Bidding Program (Round 2) officially went into full effect for us here in MA as of July 1st.
What does that mean for Allcare Medical Supply? Since we chose not to "bid" on any of the items that were included, we are not considered to be a Medicare contracted supplier for these items. With this Competitive Bidding program, Medicare members are required to purchase certain items and supplies (included in Round 2 of this program) ONLY from Medicare contracted suppliers. They must purchase from these contracted suppliers if they wish to receive Medicare benefits. In other words, they have to use a contracted supplier if they want Medicare to pay for their typical 80% portion of the item. The list of items included in Round 2 of this program can be found on Medicare's website.
If a patient comes into our store and is looking to purchase a walker, for example, and they are looking to have Medicare cover their portion, we will not be able to provide it for them. Even though we are a Medicare supplier, and even though we have the walker right there in our store, Medicare will not pay for the walker. We will need to refer the patient to a Medicare Contracted Supplier. Medicare members can go to the CMS website to try and search for a contracted supplier in their area. When I do a search for our zip code, 01527 to look for a supplier for "Walkers and related Accessories" there are 10 matches. Only 1 of them is within a 10 mile radius. The furthest result is over 1900 miles away in Duncanville, Texas! Doesn't seem like the best option for someone who came into our store looking to leave with a walker today.
What makes me sad about this whole situation, is that most customers may not fully understand that we have no choice in the matter. Its not that we don't want to help them. And its not that we don't want to give them the walker, But we are literally incapacitated to do anything about it.
Medicare beneficiaries are encouraged to contact the Medicare Beneficiary Hotline at 800-404-8702 to report the difficulties and hardship that this new program is placing on them. Doctors, healthcare professionals and referral sources are encouraged to contact the CBIC liason for their region. For our area in the state of MA, this would be Edward McGuire at 508-853-1784. You can also email Edward.
It is our hope that we are able to continue offering our patients quality care and service. We're always looking for ways to make the process easier, not more complicated. Unfortunately, this Competitive Bidding program makes that near impossible. While only a small amount of products are currently affected by this program, we shudder to think that this is only a foregleam of future plans to encompass all of our products.
For more information for beneficiaries who currently receive monthly supplies included in the Competitive Bidding program (such as mail order diabetic supplies and oxygen supplies), try this website which has some FAQ's on what to do next.