Round 2021: Timeline, categories vex stakeholders

Legislation to carve out vents expected to be introduced
Friday, March 15, 2019

WASHINGTON – CMS has set an “aggressive” timeline for HME providers to gear up for Round 2021 of competitive bidding, industry stakeholders say.

The agency on March 7 announced plans for the next round of the program, including new product categories, and outlined its projected schedule, with education and registration set to begin in May and the bid window set to open in June.

“That’s an incredibly short timeframe given the significant difference in the lead-item pricing model,” said Cara Bachenheimer, head of the government affairs practice at Brown & Fortunato. “I am concerned about the lack of time to make sure people get comfortable with this.”

CMS hasn’t announced yet how long the bid window will be open for Round 2021, but Bachenheimer expects it will be 60 days as in previous rounds.

Also cause for concern: CMS has added non-invasive ventilators to the program, despite widespread opposition from stakeholders across the healthcare continuum, who submitted between 500 and 600 comments on the proposal in December.

“We’ve already begun talking to the House and Senate folks,” said Jay Witter, senior vice president of government relations for AAHomecare. “They are taking this issue very seriously on the Hill and folks are asking questions.”

Several groups outside of the HME industry have begun talking about taking the lead on possible carve-out legislation to remove vents from bidding, says AAHomecare’s Tom Ryan.

“From the standpoint that patients and physicians believe it’s not a proper product category, they would be a much better group to be leading that legislation,” said Ryan, president and CEO. “They are already working on strategy and they have people in mind.”

The vent problem aside, stakeholders were otherwise pleased to see many of their recommendations incorporated in the program, including licensure and accreditation requirements and bid bonds, which they say will cut down on speculative bidding that saw contracts awarded to companies that were located hundreds or thousands of miles away.

In addition to non-invasive vents, CMS has added off-the-shelf back and knee braces for a total of 16 discrete product categories; and consolidated the competitive bidding areas included in Round 1 2017 and the Round 2 Recompete for a total of 130 CBAs.

Not included in Round 2021: a national mail-order program for diabetes testing supplies. The Balanced Budget Act of 2018 mandated several changes to the program, including strengthening the 50% rule and codifying the anti-switching rule.