VGM & ASSOCIATESHealthcare MSO

The Positives and Negatives of Competitive Bidding Round 2021

Published in Member Communities on November 04, 2020

There are many aspects of competitive bidding, and there are both positives and negatives to the decisions CMS decided to take Round 2021.   

In VGM’s conversations with, and in comment letters submitted to CMS leading up to their recent decision, our requests always included the following components: 

  1. Delay competitive bidding (this made sense from a demand and any-willing-provider standpoint) 
  2. Continue the blended rates for rural and non-rural non-CBA areas, but also extend the 75/25 blended rates into the CBAs as well; the blended rates for both CBAs and non-rural, non-CBAs would need to continue until the next time those products could be re-bid under a fair bid program. 

We were adamant that simply honoring request #1 above without also honoring #2 would not be sufficient and would result in access to care issues for several products in several areas. Unfortunately, they did not listen and did not implement both of our requests. Instead, they simply removed the 13 categories and left the pricing for the competitively bid products as is for the CBAs. VGM is not 100% satisfied with the outcome of Round 2021. While there were some insufficiencies that were addressed longer term, like the continuation of the 50/50 blended rates for rural areas, there were others that were completely neglected. With the high rate of DME business closures that continues to exist, it remains clear that the rates that came out of the previous rounds of competitive bidding remain unsustainable for too many businesses. While rural areas will continue to receive relief in the form of higher payments, the non-rural, non-CBAs will only receive relief through 4/1/2021 or the end of the PHE, and CBAs will receive no relief at all, except for a CPI-U increase. These areas still need to be addressed. VGM remains committed to finding a solution that offers relief to our members in ALL areas of the country.  

Together we will stay the course. We will continue to... 

  • Pull the Good, Bad & Ugly from the 200+ page proposed rule and keep you updated. 
  • Focus on Budget Neutrality (HR8158) during the lame duck session. 
  • Prepare a template for our membership to utilize during the comment period once announced.  
  • Work with industry stakeholders on CBA & Non-Rural relief to address unsustainable rates once the PHE concludes or April 1 (whichever is later).   

TAGS

  1. cms
  2. competitive bidding
  3. vgm
  4. vgm government

Get Connected

Stay up-to-date on the latest resources and news provided by VGM & Associates.

Sign Up for Email

From Our Experts

Elevate Your Expertise in Home Accessibility with Certified Installer Training thumbnail Elevate Your Expertise in Home Accessibility with Certified Installer Training VGM Live at Home, in collaboration with longtime member Access to Independence, is proud to present the upcoming Certified Installer Training, taking place September 22-25 in Ravenna, OH. Honoring ADA: Heroes of DMEPOS thumbnail Honoring ADA: Heroes of DMEPOS Celebrate the vital role of DMEPOS and home healthcare, honoring the heroes empowering patients' accessibility and independence. Streamlining Processes and Enhancing Profitability in the Repair Department thumbnail Streamlining Processes and Enhancing Profitability in the Repair Department In the complex rehab technology industry, efficient and profitable repair departments are crucial for maintaining customer satisfaction and business growth. The Cost of Not Doing Your Due Diligence When Considering a New Billing System thumbnail The Cost of Not Doing Your Due Diligence When Considering a New Billing System For providers large and small, a reliable, accurate, and efficient billing system is essential for ensuring smooth, financial transactions and maintaining healthy cash flow. Bipartisan Medicare O&P Bill Introduced thumbnail Bipartisan Medicare O&P Bill Introduced In a timely move ahead of next week's NAAOP Legislative Fly-In, a bipartisan group of lawmakers introduced the Medicare Orthotics and Prosthetics Patient-Centered Care Act, a bill aimed at improving access to high-quality orthotic and prosthetic care for Medicare beneficiaries. The Patient-Centered Care Act seeks to address critical gaps in Medicare coverage for orthotic and prosthetic (O&P) services. Under current rules, beneficiaries may receive devices without the necessary clinical services Meet the VGM Live at Home Team! thumbnail Meet the VGM Live at Home Team! The first half of 2025 has brought exciting developments and fresh momentum to Live at Home, underscored by the integration of the VGM Member Success Team. Customization, Communication, and Clinical Strength: The Indie Edge in Complex Rehab thumbnail Customization, Communication, and Clinical Strength: The Indie Edge in Complex Rehab Independent complex rehab providers say they are differentiating themselves with product customization and referral and patient engagement. The Rising Cost of Doing Business in the Mobility and Complex Rehab Technology Industry thumbnail The Rising Cost of Doing Business in the Mobility and Complex Rehab Technology Industry This article delves into concerns of rising costs in the mobility and complex rehab technology (CRT) industry and explores potential strategies to mitigate their impact.

Give your business an advantage over the competition.

Become a Member