We are receiving countless requests for “sample expansion plans”. 

 VGM cannot offer financial, operational or legal advice in this regard. 

 However, one VGM member has allowed us permission to forward HIS generic “sample plan”. 

 IMPORTANT – READ THIS –

 •IMPORTANT CAVEAT AND DISCLAIMER; NO WARRANTY:   This is not a VGM work-product.  This reprint of an actual supplier’s “expansion plan” is distributed in the hope that it will be useful, but WITHOUT ANY WARRANTY; without the implied warranty of FITNESS FOR A PARTICULAR PURPOSE. THERE IS NO WARRANTY FOR THE DOCUMENT TO THE EXTENT PERMITTED BY APPLICABLE LAW.   VGM GROUP, INC. PROVIDES THE DOCUMENT “AS IS” WITHOUT WARRANTY OF ANY KIND, EITHER EXPRESSED OR IMPLIED, INCLUDING, BUT NOT LIMITED TO, THE IMPLIED WARRANTIES OF FITNESS FOR A PARTICULAR PURPOSE. THE ENTIRE RISK AS TO THE QUALITY AND PERFORMANCE OF THE DOCUMENT IS WITH YOU. IN NO EVENT UNLESS REQUIRED BY APPLICABLE LAW OR AGREED TO IN WRITING WILL VGM GROUP, INC BE LIABLE TO YOU FOR DAMAGES, INCLUDING ANY GENERAL, SPECIAL, INCIDENTAL OR CONSEQUENTIAL DAMAGES ARISING OUT OF THE USE OR INABILITY TO USE THE DOCUMENT (INCLUDING BUT NOT LIMITED TO LOSS OF DATA OR DATA BEING RENDERED INACCURATE OR LOSSES SUSTAINED BY YOU OR THIRD PARTIES OR A FAILURE OF THE DOCUMENT TO OPERATE AS IT IS INTENDED) EVEN IF SUCH HOLDER HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES.

————————————————–

 Staff Current

Currently we do not have staff in the (appropriate CBA).  All of our product management, inventory, customer service and billing takes place out of our __________________ headquarters which is located __________ miles from the (appropriate CBA). 

 Staff Expansion

We are hiring intake and delivery personnel to handle new patients in this CBA, as well as sales representatives to work with referral sources.  Our delivery personnel will handle patient education at the time of delivery.

 Finance Current

We are properly capitalized with the personal commitment of the owners to fund our growth.  We have two lines of credit at different banks.  We have open account status at over 24 different manufacturers that suffice for our cash flow needs.

 Finance Expansion

We anticipate our current financing will be sufficient to handle our growth into this CBA.  Additional credit line increases could be obtained by suppliers and our banks if needed.  Our owner’s net worth was too great to qualify for an SBA loan, and he is committed to finance our future growth in this CBA.

 Facilities Current

Our current facilities are located in ______________, which includes our headquarters, retail location, billing, customer service and warehousing operations.

 Facilities Expansion

We believe our current facilities can handle the growth of this CBA, particularly with the availability of vendor drop ships.  As growth dictates, we would eventually add a regional warehousing operation to insure timely availability of product.

 Inventory Control Current

We use _________________________ software to manage all aspects of billing, inventory control, and patient care.

 Inventory Control Expansion

We will use the additional location feature of (Software) to manage any remote inventory needed in this CBA.

 Distribution Current

We currently drop ship all items into this CBA from the manufacturer or our headquarters

 Distribution Expansion

We will continue to drop ship items into this CBA, and add a regional distribution facility when necessary and cost effective.

 Additional Information Current

We have developed our internal processes so that we have developed a smooth patient experience with excellent customer care, and have streamlined the paperwork and billing processes through training personnel in (Software) and the CMS system.  We have grown beyond simply being a regional supplier, and have obtained licensing to be approved in ____ states for Medicare.  We have assembled a team of veteran HME and medical office experienced staff, with over ___ years of combined experience in the industry.

 Additional Information Expansion

We plan to leverage the talent we have assembled in our headquarters to continue to grow our customer base through providing excellent patient care and customer service.  Our growth will depend in part on the ability of our sales representatives to develop relationships with referral sources, and the marketing presence we develop in the CBA.  We have developed an extensive training website to assist with developing and training new personnel to effectively grow this business.

A most common question:  How do we “finalize” our bid?  See reprint below from an actual HME transcription with the CBIC….

 ACCORDING TO “JENNA” AT CBIC (MARCH 23 AT 12:20 PM)… ONCE ALL THE BIDDING CATEGORIES THAT YOU WISH TO BID ON ARE MARKED “COMPLETE AND CERTIFIED” AND THE FORM A IS MARKED “COMPLETED AND APPROVED” AND DOCUMENTATION STATUS SHOWS THAT IT WAS RECEIEVED “YES”, THEN THERE IS NOTHING LEFT TO DO TO “FINALIZE” WHAT IS THERE… IT JUST STAYS THERE UNTIL THE MARCH 30TH DEADLINE.  BIDS CAN BE CHANGED UP UNTIL THE DEADLINE, BUT THE CHANGES HAVE TO BE RECERTIFIED BY AN AUTHORIZED OFFICIAL BY USING THEIR “LOGIN” ID.  THERE IS NO FINAL “MAGIC BUTTON” TO CLICK ON ONCE YOUR STATUS SCREEN SHOWS THESE THINGS.

 A copy of the official final recommendations from the CBIC follows:

 All bids must be submitted in DBidS, the online bidding system, by 8:59:59 p.m. prevailing Eastern Time on Friday, March 30, 2012. All required hardcopy documents that must be included as part of the bid package must be RECEIVED by the Competitive Bidding Implementation Contractor (CBIC) on or before March 30, 2012.

 Here are some important reminders:

 •The Round 2 and national mail-order competitive bidding areas, product categories, DBidS information, bid preparation worksheets, educational materials, and complete Request for Bids (RFB) instructions can be found on this website, www.DMECompetitiveBid.com. You should review this information prior to submitting your bid(s).

•You must submit your bid in DBidS using the user ID you received during registration. If you have not already logged in to DBidS, we strongly recommend that you do so NOW to have plenty of time to complete your bid. If you have forgotten your user ID and/or password, you may recover them by using the “Forgot Your User ID?” and “Forgot Your Password?” buttons located on the Individuals Authorized Access to the CMS Computer Services (IACS) login page.

 •Your authorized official or backup authorized official must approve your Form A and certify your Form B before the close of bidding. If you modify your bid after it has been approved or certified, it will need to be reapproved or recertified. If Form A is not approved or Form B is not certified, your bid cannot be evaluated, and you will not be considered for a contract. You can verify the status of your forms by logging into DBidS and checking the status screen.

 •All bidders must submit certain required hardcopy documents as specified in the RFB instructions. It is very important that you review the hardcopy documents section and the sample financial statements in the RFB instructions to ensure your documents include the required information. We also encourage you to use the Hardcopy Document Package Checklist, which may be found in Appendix B of the RFB. If you have already submitted your financial documents, you may still amend those documents as long as they are RECEIVED by the CBIC on or before March 30, 2012. We cannot accept faxed or e-mailed documents, so you must mail your documents to the CBIC at the address in the RFB instructions.

  •All bidders participating in the national mail-order competition for diabetic testing supplies must complete and submit the National Mail-Order 50 Percent Compliance form on the CBIC website. Only one form should be submitted per bidder number. You must not change the printed form in any way. Please ensure that all pages of the form are included in the hardcopy document package. If the form is not RECEIVED on or before March 30, 2012, your bid for the national mail-order competition will be disqualified. Please refer to the instructions on the form or to the National Mail-Order Competition for Diabetic Supplies fact sheet on the CBIC website for additional information.

 • If you submitted financial documents by the covered document review date (CDRD) – February 29, 2012 – you will receive an e-mail about your financial documents from the CBIC by May 14, 2012. If you did not submit all of the required financial documents, the e-mail will alert you to expect a letter notifying you of the specific missing financial document(s). This letter will be mailed to your organization’s authorized official. You will be required to submit the indicated missing financial document(s) within 10 business days of the notification. If you submitted all required financial documents, the e-mail will confirm that the CBIC received all required financial documents and that no further action from you is required. If you did not submit any financial documents by the CDRD, you will not receive an e-mail or a letter about your financial documents.

 •If you did not submit any hardcopy financial documents by the CDRD, you are still required to submit all required hardcopy documents specified in the RFB instructions on or before Friday March 30, 2012.

 If you have any questions, please contact the CBIC customer service center at 877-577-5331 between 9 a.m. and 9 p.m. Eastern Time.

 For most of you, the only item to physically forward to the CBIC will be a LOI, if applicable.  Diabetic mail order bidders should include the compliance form noted above.  Hard copies of your bidding worksheets are NOT to be sent.  If you have had an increase in credit score or updated financial documents, these also may be updated.  Please include your bidder number on all documents and, in the case of updated financial information, a date on each page. 

 Good luck to all. 

 Please read all posts for additional information here http://www.vgm.com/blog/index.php/category/regulatory/

Readers may find the following reprints of interest. 

These are a sampling of the 250+ actual email inquiries we received this week. 

As you will note, some questions are timely and most suitable.  Others are, well…we must just hope that these companies do not make serious errors or offer unsuitable bids. 

The purpose of this email is not necessarily “instruction” or “guidance” as previous Blog updates were intended.  Rather, I’d like to share with our VGM members and affiliated companies a sampling of the issues that appear to remain unclear to many HMEs. 

Lastly, before I begin the reprint, many replies have been shortened and/or edited for space purposes.  If any appear “curt” or blunt, it was certainly not my intention. 

Please click here: http://www.vgm.com/files/PDF/RoundTwoNCBLastMinuteFAQs.pdf

This seems to be a popular question and a concern.  Readers have noted that we continue to suggest to offer a modest capacity – per previous email correspondence such as  http://www.vgm.com/files/PDF/TheBiddingCapacityIssue.pdf – and are curious as to whether they may input a number LOWER than their current array of FFS Medicare business.  The short answer is yes.  Patients may migrate to Medicare HMOs (exempt from NCB) and there is no guarantee in the program that reimbursement levels will remain constant, among other issues. 

We discussed the matter with the healthcare law firm of Brown and Fortunato.  A reprint follows below:

 All:

 Jeff asked that I look at and respond to the email below regarding estimated capacity.

 I looked through all of the guidance I could think of (regs, RFB, fact sheets, DBidS Reference Guide), and the only explanations of or guidance regarding estimated capacity that I could find mirrored that in #2 below. Page 40 of the DBidS Reference Guide states that total estimated capacity “indicates the number of units per HCPCS code that [the supplier] estimates [it] can provide throughout the entire CBA for this product category for one (1) year. . . . To determine capacity for each HCPCS code, calculate the number of units that you currently furnish on a yearly basis and add any additional number of units or capacity you would be capable of providing annually at the start of the contract period.”

 After looking at the written guidance, I called Elena Armstrong (Dallas area CBIC Ombudsman), and she told me that it was perfectly fine to report an estimated capacity lower than the level historically provided. However, we also discussed the contract term which states that suppliers must agree to furnish covered items under their contracts to any beneficiary who maintains a permanent residence in or visits a CBA and requests those items from the contract supplier. See 42 C.F.R. § 414.422(e)(1). Therefore, it is not as though reporting a lower estimated capacity will enable a contract supplier to turn away excess beneficiaries.

 Elena told me that she would be glad to provide me with something in writing that states it is okay to report an estimated capacity lower than that previously provided. If you would like me to get that and forward it on to you, let me know.

 Regards,

 Todd A. Moody

905 S. Fillmore, Ste. 400

Amarillo, TX 79101

(806) 345.6343 (direct)

(480) 695.5487 (mobile

(806) 345.6363 (fax)

tmoody@bf-law.com

1.    – from Form B- the bidding sheet

It is anticipated that suppliers will be capable of sustaining the same level of estimated capacity throughout the entire contract period. Please refer to the Bidding Information Chart titled “Estimated Capacity and Bid Amount Worksheet” at www.dmecompetitivebid.com/bic for the definition of a unit for each item.

• Fee Schedule – This indicates the fee schedule amount for the HCPCs code in this CBA. For items included in

 2.      Request for Bid- page 15

Total Estimated Capacity – Requires suppliers to provide their expected capacity. The total estimated capacity indicates the number of units per HCPCS code you estimate you can furnish throughout the entire CBA for one (1) year. The bid preparation worksheet on the CBIC website contains the unit by product category definitions. To determine your expected capacity, calculate the number of units you currently furnish in the area on a yearly basis and add units you would be capable of providing annually as of the start of the contract period. It is anticipated that suppliers can maintain this level or greater throughout the contract period.

————————————————————————————————————————-

More issues to follow later today.  And remember…Do NOT overestimate capacity (please…)  There are no limits to what you may be reimbursed in a particular product category.  Round one rebidding companies that offered a double or triple capacity bid compared to their current patient census resulted in lowering the allowable by up to five additional percentage points. 

We  had a member speak to Anise Reed at the CBIC with regard to whether current agreements with vendors (such as liquid oxygen services) would be considered subcontracting under the Round 2 program.  

The response:  She indicated that HMEs should submit a letter of disclosure regarding current contracts with these vendors (such as LifeGas or Air Gas) that will perform future subcontracting duties under the program guidelines.  She directed us to the Contract Suppliers section of the website and then to Subcontractors.  This is the applicable paragraph:

Contract suppliers must identify the name of the subcontractor, the address of the particular location that will perform the subcontracting service (corporate headquarters’ addresses are not acceptable), the services to be provided by the subcontractor, and whether the subcontractor is accredited, as applicable. For your convenience, we have provided a sample subcontractor disclosure form. Please submit the required information to the Competitive Bidding Implementation Contractor (CBIC) as directed on the sample form.

HMEs may submit a completed disclosure form (included on the website).  She also indicated that suppliers should send “a letter of explanation” to the CBIC, and “someone from LifeGas should sign the letter as well”. 

I have not been aware of this issue and it arguably has been under the radar.  There are hundreds of HMEs currently using these services, and I will fathom that very few eligible for the Round Two program have considered this and/or completed these steps as advised by the CBIC above.

FYI…

In any case, please do not contact me regarding this issue at this time, as I have no authority to comment or advise.  Please contact the CBIC directly at 1-877-577-5331.

Thank you

This post is a follow up to several comments I received in reply to the “bid calculator” demonstration released by email and blog (see the previous post) earlier today. 

 Here is an example that is representative of others:

Mark,

I think we now better understand how the discount and the weighting affects the composite bid.  But I think everyone’s misunderstanding is more specifically the capacity that we have to enter on the Bid Sheet.   Several HCPCS codes we have never billed before.   I understand it has to be 1 or more for the form to be accepted.  When we all compare the Bid Prep worksheets that shows the capacity for each CBA, I believe we all get more confused because we all feel that we have to be able to provide at least 1% capacity which in most case is more than 1 unit which is required to be in the capacity on the bid sheet.

To read my reply and comment, click here: 

http://www.vgm.com/files/PDF/TheBiddingCapacityIssue.pdf

As always, email me with questions!!

I am still receiving numerous inquiries as to the method that CMS determines a “winning bidder”.  The issues of capacity and the agency’s “HCPC weight” continues to confuse many.

 With that said, I’d like to offer a step-by-step guide with commentary as to some nuances of the program. 

Click here and email with questions!  http://www.vgm.com/files/PDF/Round-Two-Bidding-Help_Bid-Calculators.pdf

We have received dozens of these inquires:

My question: Under Support Surfaces the HCPC code E0193 refers to Low Air Loss beds that as far as I can tell are products we can’t supply because they are exclusive to Hill-Rom and KCI. Any suggestions about this code?

VGM has posted the following at http://campaign.r20.constantcontact.com/render?llr=nx4vybeab&v=001Kq5KIUlW9l2d6wldkavioBbGXsre09gmUAPmRNhKbLqHY5d4X4ybdJsWRn30BhzaNgIAPSA4sBtziJsfAkUQHbia8poY81HGIR73b6lEaR7S8xcmBDIz9mx1wfXspqw5vrPBOWDikMx4634jwTrLO1jBkSG9_Q5ZwxB-RjfdEalAWBhQSQOdhdoMluBGLa5j3wF-T5ViEwL_uR6_XcN6u116xBAyfy_JqZ54f3pcGEA%3D

Blue Chip Medical Products, Inc.
Offering Competitive Bidding Solutions!

E0193 is considered an “integrated low air loss bed system.” That would be a powered bed with a low air loss mattress built into the bed frame. The odds of ever using this code are slim, however, Blue Chip now has an E0193 product.  Call us for pricing.

The submission deadlines for competitive bidding are rapidly approaching! Blue Chip Medical Products is here to help you WIN.

One of our goals as a manufacturer is to give VGM members the ability to compete in all areas of health care. Blue Chip can provide VGM members with the products and clinical expertise that will allow you to grow your business in this very precarious marketplace.

Our program consists of educating you on how to effectively go after the therapeutic support surface business in your service area.

If you are looking to aggressively pursue profitable areas of business for 2012, Blue Chip has the right program for you.

Pressure mapping provides accurate, valuable insight to help determine and implement optimal seating solutions. Blue Chip, in conjunction with Vista Medical, is pleased to offer a new stretch seat, back and bed sensing mat.

Order your stretch sensing back and get a  FREE tablet computer. No other therapeutic support surface measures up to Blue Chip. Affordable, reliable, effective.

Blue Chip Medical Products, Inc.

7-11 Suffern Place
Suffern, NY 10901
tel: 800 795-6115
fax: 845 369-7633
sales@bluechipmedical.com

We have discovered a bug in the VGM Bid Calculator Worksheets at http://www.vgmncbservices.com/bid_calculators.asp. 

In all 100 CBA worksheets the oxygen category (only) includes 5 “payment class” cells in which potential bidders can enter a fixed “desired” bid amount in column G, or a bid discount percent in column H. 

Column M indicates the percentage of the overall composite bid that the five payment categories represent.  The software will sum the input and indicate a discounted composite bid in cell L20 and the overall category discount in cell L21. 

The bug exists in that the category discount did not reflect Payment Class “B”, the Portable Equipment Only class.  The composite bid amount was accurate (and hence there are no issues of an erroneous dollar amount)…but the overall category discount appeared less than the input data.

We are correcting all 100 files now. 

If you would like to manually correct a downloaded copy, it is easy: 

Unhide Column F.  This may be done by shifting and putting your cursor over columns E and G.  Hold the shift and right click the “Unhide” option.  Column F will appear!  The second of the five weighted bid limits (Portable Only) in this column is blank.  Simply copy the function of d7 * e7 and then the correction will take place.  Resave the file (or simply download the updated one from the link above; these will be complete by 1:00 CST today).

Thank you.

I’m receiving many questions relative to the financial documents…such as “what pages of the tax return do I send in?”   All bidders should read EVERY section of the financial documents checklist.  Go here (and your answers should be answered!)…

http://www.dmecompetitivebid.com/Palmetto/Cbic.Nsf/files/R2_Financial_Documents_Chart.pdf/$File/R2_Financial_Documents_Chart.pdf

Need additional help?  Click below and start reading!

http://www.dmecompetitivebid.com/palmetto/CBIC.nsf/DocsCat/CBIC~Bidding%20Suppliers%20Round%202%20National%20Mail-Order~Bid%20Evaluation~8P2KRU4147?open&navmenu=Bidding^Suppliers^Round^2^National^Mail-Order||||&navmenu=Bidding^Suppliers^Round^2^National^Mail-Order||

Remember to ship your hard copy package prior to February 29.

(If you don’t know why then you didn’t read the info in the links above…)