VGM Government Relations Releases Updated Study with Leitten Consulting: Competitive Bidding: A Decade Focused on the Wrong Prize

Published in Government Relations on October 19, 2021

VGM Government, in conjunction with Brian Leitten and Leitten Consulting, has released an updated study analyzing the efforts by CMS to control distribution of Durable Medical Equipment (DME). The study, “Competitive Bidding – A Decade Focused on the Wrong Prize. The Case for Medicare Investment in DME in 2021,” looks at how competitive bidding did generate savings and reduce fraud in the system, but missed an even larger opportunity, investing in DME.

“The costs that CMS saved over a decade of focusing on the wrong prize pale in comparison to the real prize, reducing the cost of treating injuries and illnesses that befall Medicare beneficiaries who lack the critical DME they need to stay well,” stated Brian Leitten, head of Leitten Consulting. “CMS continues to bear this enormous cost, which has constantly grown over the decade and now stands at an estimated total of $98 billion annually in three key DME categories – mobility DME, oxygen therapy, and CPAP therapy equipment and supplies.”

In 2010, VGM engaged Leitten Consulting to chronicle the impact of competitive bidding and quantify the potential to reduce the spending that resulted from not proactively getting DME to Medicare beneficiaries. The original study published in 2011 and the updates that followed established the power and leverage of investing in DME and confirmed the opportunity for CMS to drive down the massive payments it makes to treat the very problems that DME is designed to avoid.

“Whenever there is a new program implemented, there will be short and long-term impacts,” says John Gallagher, vice president, VGM Government Relations. “When competitive bidding started 10 years ago, we knew we wanted to track the impacts it would have on our members so we could proactively engage with CMS on recommendations to the program to make sure our members’ voices were being heard.”

The study looks closely at the costs associated with falls, Chronic Obstructive Pulmonary Disease (COPD), and Obstructive Sleep Apnea (OSA) and how investing in DME could save $98 billion annually. Read the full study, paid for by the Last Chance for Patients Choice (LCPS), HERE


TAGS

  1. cms
  2. competitive bidding
  3. vgm government

From Our Experts

Tom Powers Visit Washington D.C. thumbnail Tom Powers Visit Washington D.C. With the start of the 118th Congress and all members of Congress returning to D.C., VGM Government Relations' Tom Powers headed to Capitol Hill. OIG Recommends 'High/Low Reward' Strategy on Intermittent Catheters thumbnail OIG Recommends 'High/Low Reward' Strategy on Intermittent Catheters In this episode of Industry Matters, Alan Morris, Director of Research and Strategy for VGM Government Relations, and John Gallagher, VP of VGM Government Relations, talk with Brian Leitten from Leitten Consulting, about a new study, "OIG Recommends 'High Risk/Low Reward' Strategy on Intermittent Catheters." The study looks at concerns and costs associated with reducing access to urinary catheters. Additional HCPCS Codes Added to F2F/WOPD Required List thumbnail Additional HCPCS Codes Added to F2F/WOPD Required List On Jan. 14, 2023, CMS released a public notice CMS-6088-N, adding 10 more HCPCS codes to the F2F/WOPD Required List. Ronda Vlog: Recent Updates to the New Oxygen Policy thumbnail Ronda Vlog: Recent Updates to the New Oxygen Policy Listen below as Ronda Buhrmester, Sr. Director of Payer Relations and Reimbursement gives the latest update on the new oxygen policy. Republicans Announce New Members on Key Committees thumbnail Republicans Announce New Members on Key Committees On Wednesday, Jan. 11, 2023, the United States House Republican Select Committee met to announce the new Republican members appointed to various committees in the House. For the DME industry, there are three key committees of justification to work with. PHE Renewed for Another 90 Days Pushing it to April 2023 thumbnail PHE Renewed for Another 90 Days Pushing it to April 2023 On Wednesday, Jan. 11, 2023, HHS Secretary Xavier Becerra announced an extension of the COVID-19 Public Health Emergency (PHE). This extension will take us to April 2023. Be sure to read how this will effect the industry. President Biden Signs Omnibus Bill Two Days Before The New Year thumbnail President Biden Signs Omnibus Bill Two Days Before The New Year Yesterday, Dec. 29, 2023, President Biden signed the end-of-year omnibus bill. Within this bill, there is a language for the DMEPOS industry. Ronda Vlog: CGM Coding Reminder thumbnail Ronda Vlog: CGM Coding Reminder Listen below Ronda Buhrmester, Sr. Director of Payer Relations and Reimbursement gives an update on the CGM coding coming in 2023.