Originally Published MDDI April 2004

NEWSTRENDS

Erik Swain

AdvaMed (Washington, DC) has written a strongly worded letter to the Centers for Medicare and Medicaid Services (CMS; Baltimore) condemning a competitive bidding demonstration project for clinical laboratory tests as it has been proposed.

Competitive bidding, the association said in the March 3, 2004, letter, will lead to “a selection process that, over time, by its very nature, will significantly reduce the number of entities to which Medicare providers and beneficiaries will have access.” By contrast, it said, the current system allows beneficiaries to have access to “any willing provider.”

It said the pilot project will be problematic if it follows the same procedures as one conducted for competitive bidding on durable medical equipment.

Questions relating to cost, access, logistics for practitioners, beneficiary protections, and fairness were not adequately addressed during the durable medical equipment pilot, AdvaMed said. It also stated that statistically valid measures were not established for the measurement of access and quality, and the comparison of lower prices to diminished services. Nor, it said, have concerns about that project's bidding process, evaluation, and costs been addressed. 

Therefore AdvaMed recommended these measures, among others, for the lab-test project:

• Establish an independent, non-CMS advisory committee.
• Seek guidance from stakeholders in the laboratory community, and allow all phases of the project to be open to review and discussion.
• Make the bidding process an open one in accordance with Federal Acquisition Rules.
• Establish statistically valid measures that total potential costs of the project.
• Allow multiple winners, enabling anyone who was close to the winning bid to participate.
• Make provisions assuring that beneficiaries will have access to new testing technologies.

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