NASL issued a statement to the press on Friday, Feburary 1, 2013, in response to the January 31st announcement by the Centers for Medicare & Medicaid Services (CMS), which stated that rates for Durable Medical Equipment, Prosthetics, Orthotics & Supplies (DMEPOS) would be cut an average of 45 percent beginning in July 2013.

NASL Statement on Medicare Competitive Bidding Round 2

NASL has serious concerns about the deep payment cuts to Durable Medical Equipment, Prosthetics, Orthotics & Supplies (DMEPOS) announced by the Centers for Medicare & Medicaid Services (CMS) this week. Cutting DMEPOS rates by an average of 45 percent beginning in July 2013 far exceeds what was expected for Round Two of CMS’ contested Competitive Bidding Program.

Such deep cuts could have a devastating impact on companies that supply these products and the patients they serve.

CMS estimates that the resulting payment levels for enteral nutrition formulas, equipment and supplies will be 41 percent less than Medicare’s current fee schedule amounts. “We are extremely concerned that that the payment levels will not enable quality suppliers to continue to deliver the level of care they currently provide to patients,” remarked NASL Medical Products Committee Chair David Lefkowitz, who is the director of customer relations for Stonebridge Medical, based in New York. “It appears that the government’s zeal for cost savings may have obscured its view of what is actually required to provide quality care.”

“The fee schedule amounts for enteral products under Round Two of Competitive Bidding may not reflect the totality of costs incurred when providing enteral products to residents of nursing facilities,” continued Lefkowitz. “This is not surprising, since by definition the current competitive bidding system requires one-half of the winning bidders to accept payment amounts that are less than their bids. It is not clear at all that CMS exercised proper and reasonable discretion in determining what is a responsible bid when its process yields results of this kind.”

“NASL is eager to learn what assumptions CMS used in evaluating the ability of those with winning bids to deliver quality care,” explained NASL Executive Vice President Cynthia Morton. “A supplier that provides enteral nutrition for nursing facility residents, for example, does far more than simply deliver product to the facility. Enteral nutrition suppliers also must be able to track various formulas and interact with the nursing facility’s clinical staff to ensure that patients receive the proper enteral formulas as ordered by their physicians.”

Morton continued, “NASL wants to better understand the process CMS used to determine that the suppliers that won these bids can deliver quality products and services – and in the case of enteral nutrition supplies – at 41 percent less cost than the fee schedule currently allows.”

NASL remains committed to working with Congress to develop a payment system that accurately reflects the true market for the provision of DMEPOS products and service to Medicare beneficiaries.

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