The introduction of stand-alone competitive bidding legislation by Sen. Bob Graham (D-Fla.) on Oct. 10 indicates the uncertainty of passing a Medicare provider giveback bill before Oct. 18, when the 107th Congress plans to adjourn.

The "Medicare Competitive Acquisition Act" of 2002, co-sponsored by Sen. Phil Gramm (R-Tex.), is similar to competitive bidding provisions in the provider giveback bill (S 3018) introduced Oct. 1, with several exceptions.

While S 3018 phases in competitive bidding over four years beginning in 2004, the Graham bill implements the program over a five-year period beginning in 2003.

In addition, the Graham legislation defines the criteria for a competitive acquisition area as simply a "metropolitan statistical area," leaving the exact definition of that term open to interpretation. By contrast, the giveback bill explicitly defines an MSA as an area with a population exceeding 500,000.

The competitive bidding bill retains many of the provisions of S 3019, the "Beneficiary Access to Care and Medicare Equity Act," which was introduced by Finance Committee Chairman Max Baucus (D-Mont.) and Ranking Member Charles Grassley (R-Iowa) (¹ Also see "Diagnostics Competitive Bidding Makes Provider Giveback Measure" - Medtech Insight, 7 October, 2002., p. 21).

For example, both measures authorize three competitive bidding demonstration projects for diagnostic tests. The bills also provide protections for small businesses, such as the ability to bid for one or only a few product categories in a competitive acquisition area.

Overall, the program gives CMS the authority to choose a DME manufacturer to supply products to Medicare beneficiaries based on cost.

While Senate Finance leaders are hoping to pass a provider giveback bill this session, it is looking less likely. CMS Administrator Tom Scully conceded Oct. 8 that Congress might be unable to pass provider givebacks before the November elections.

The Coalition for Access to Medical Services, Equipment and Technology, which was formed to oppose competitive bidding, maintains it will continue to lobby against the practice during the remainder of the 107th Congress.

Graham Competitive Bidding Bill Phases In Program Over Five Years

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