News in brief - March 28, 2011

Lawmakers press to repeal DME bidding

Reps. Glenn Thompson (R, Pa.) and Jason Altmire (D, Pa.) have introduced a bill to repeal Medicare's competitive bidding program for durable medical equipment, prosthetics, orthotics and supplies.

The lawmakers said the bidding process forces out smaller medical suppliers and decreases overall quality of care. "CMS' competitive bidding program limits seniors' ability to buy highly specialized medical equipment from the local suppliers they know and trust," Altmire said. Advocates say the process will save Medicare a significant amount of money and reduce the opportunity for fraud.

The Centers for Medicare & Medicaid Services has completed the first round of competitive bidding, which determined which suppliers could operate in nine major metropolitan areas. The agency has planned an April 5 forum to discuss expanding bidding to the rest of the country.

The potential Medicare savings erased by the bill, the Fairness in Medicare Bidding Act, would be offset by directing the White House Office of Management and Budget to identify and rescind $20 billion in unspent federal funds.

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Medicare inappropriately paid millions for erectile dysfunction pills

Medicare Part D plans covered $3.1 million in erectile dysfunction drugs in 2007 and 2008 despite a congressional prohibition, the Dept. of Health and Human Services Office of Inspector General has found.

Medicare payment for medications to treat sexual or erectile dysfunction were banned in 2007 by lawmakers who said it was wrong for taxpayers to subsidize seniors' recreational sex. The Centers for Medicare & Medicaid Services uses a claims edit to reject such drugs in its processing system, but the agency had been using an incomplete list of excluded drugs, according to a March OIG report.

OIG recommended that the Medicare program strengthen its internal controls and attempt to impose financial adjustments on pharmacies that were paid for providing the erectile dysfunction drugs.

The agency has since instituted the tougher controls recommended by the OIG, CMS said in a response to the report.

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AMA supports New York damage cap proposal

The American Medical Association has voiced its support of New York Gov. Andrew Cuomo's proposal to establish a state damage cap on medical liability court awards.

In a March 17 letter, the AMA said the proposed reform provides a common-sense solution that allows patients their day in court while safeguarding access to health care. Medical liability insurance premium rates for New York physicians are among the highest in the country.

The New York State Bar Assn. has denounced the plan, saying the reforms would restrict citizens' civil rights.

Cuomo's budget proposal would place a $250,000 cap on noneconomic damages and create a fund to help hospitals pay for treating neurologically-impaired infants. The state's budget must be approved by April 1.

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