The House of Representatives passed a Medicare prescription drug benefit bill June 28 that in addition to providing the drug benefit would require the Secretary to establish and implement competitive bidding programs for durable medical equipment, including some off-the-shelf orthotics Under the proposed system, the Secretary of Health and Human Services (HHS) would be required to enter into contracts with suppliers for "competitive acquisition areas" for not longer than three years in duration. The items to be subject to competitive bidding would be durable medical equipment and inhalation drugs used with durable medical equipment, as well as "off-the-shelf orthotics," defined as covered orthotics which require minimal self-adjustment for appropriate use and do not require expertise in trimming, bending, molding, assembling, or customizing to fit the patient.. Although it is unclear as to exactly which orthotic products this would include, preliminary analysis of what CMS would be required to determine through regulation would likely include approximately one-third of all orthotics.
The Senate is now considering a Medicare prescription drug package that does not currently contain competitive bidding or any other "provider giveback" provisions. However, the way the legislation is being considered leaves open the possibility that competitive bidding may be offered as an amendment. It is likely, though, that substantive action on competitive bidding will occur in September when the Senate Finance Committee will mark up a "provider giveback" package. That package will almost certainly consider competitive bidding. Until then, it is imperative to remain on guard for any possible amendments to the legislation being considered in the Senate right now as well as continue to prepare to fight competitive bidding in the fall.
