I 

113TH CONGRESS 

1ST SESSION H. R. 2375 

To delay for at least 6 months the implementation of round 1 recompete 

and round 2 of the Medicare durable medical equipment (DME) competitive bidding program and of the national mail order program for diabetic 

testing supplies to permit Congress an opportunity to reform the competitive bidding program, to provide for an evaluation of that program 

by an auction expert team, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 14, 2013 

Mr. THOMPSON of Pennsylvania (for himself and Mr. BRALEY of Iowa) introduced the following bill; which was referred to the Committee on Energy 

and Commerce, and in addition to the Committee on Ways and Means, 

for a period to be subsequently determined by the Speaker, in each case 

for consideration of such provisions as fall within the jurisdiction of the 

committee concerned 

A BILL 

To delay for at least 6 months the implementation of round 

1 recompete and round 2 of the Medicare durable medical equipment (DME) competitive bidding program and 

of the national mail order program for diabetic testing 

supplies to permit Congress an opportunity to reform 

the competitive bidding program, to provide for an evaluation of that program by an auction expert team, and 

for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Transparency and Ac3 countability in Medicare Bidding Act of 2013’’. 

4 SEC. 2. DELAY IN IMPLEMENTING THE MEDICARE DME 

5 COMPETITIVE BIDDING PROGRAM AND THE 

6 NATIONAL MAIL ORDER PROGRAM FOR DIA7 BETIC TESTING SUPPLIES. 

8 (a) IN GENERAL.—Notwithstanding any other provi9 sion of law, the Secretary of Health and Human Services 

10 shall delay from July 1, 2013, to a date that is no earlier 

11 than December 31, 2013, the dates of implementation 

12 of— 

13 (1) round 2 of the DMEPOS competitive bid14 ding program under section 1847 of the Social Secu15 rity Act (42 U.S.C. 1395w–3); and 

16 (2) the single payment amounts under the na17 tional mail order competition for diabetic supplies 

18 under such section. 

19 (b) ROUND 1 RECOMPETE DELAY.—Notwithstanding 

20 any other provision of law, the Secretary of Health and 

21 Human Services shall delay the start of round 1 recompete 

22 of such DMEPOS competitive bidding program from Jan23 uary 1, 2014, to a date that is no earlier than 6 months 

24 after the date of initial implementation of round 2 of such 

25 program. 


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1 SEC. 3. EVALUATION OF DMEPOS COMPETITIVE BIDDING 

2 PROGRAM BY AUCTION EXPERT TEAM. 

3 (a) IN GENERAL.—The Secretary of Health and 

4 Human Services (in this section referred to as the ‘‘Sec5 retary’’), not later than 3 months after the date of the 

6 enactment of this Act and acting through the Office of 

7 the Assistant Secretary for Planning and Evaluation, shall 

8 contract 3 auction experts, a health economist, and an 

9 econometrician to work as a team (in this section collec10 tively referred to as the ‘‘auction expert team’’), led by 

11 the auction experts, to independently review and assess all 

12 aspects of round 1 re-bid and round 2 of the DMEPOS 

13 competitive bidding program under section 1847 of the 

14 Social Security Act (42 U.S.C. 1395w–3), including the 

15 design, development, implementation, adequacy of support 

16 for Medicare beneficiaries with chronic illness or disabil17 ities, market fairness, sustainability, and functioning of 

18 such program. 

19 (b) SELECTION OF AUCTION EXPERT TEAM.— 

20 (1) IN GENERAL.—The selection of the experts 

21 on the auction expert team under subsection (a) 

22 shall be undertaken through a competitive process. 

23 (2) DISQUALIFICATIONS.—An individual shall 

24 not be selected for the auction expert team if such 

25 individual— 


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1 (A) is a current or former employee of the 

2 Centers for Medicare & Medicaid Services; 

3 (B) is a current or former contractor for 

4 the Centers for Medicare & Medicaid Services 

5 that participated in the design or implementa6 tion of the DMEPOS competitive bidding pro7 gram; 

8 (C) does not have significant experience in 

9 implementing auctions of similar complexity in 

10 government programs; and 

11 (D) does not have appropriate educational 

12 credentials. 

13 (c) ACCESS TO INFORMATION.—The Secretary shall 

14 make available to the auction expert team all applicable 

15 information (including confidential information) on the 

16 DMEPOS competitive bidding program in its entirety (in17 cluding information on its design and the bidding under 

18 round 1, round 1 re-bid, and round 2). 

19 (d) REPORT TO SECRETARY AND CONGRESS.— 

20 (1) IN GENERAL.—Not later than 4 months 

21 after the date the Secretary enters into the contract 

22 with the experts under subsection (a), the auction 

23 expert team shall submit a report to the Secretary 

24 and to the Congress on its assessment and review 

25 under subsection (a). 


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1 (2) ITEMS TO BE INCLUDED IN REPORT.—Such 

2 report shall include the following and shall identify 

3 all potential problems with the DMEPOS competi4 tive bidding program: 

5 (A) A review and assessment of the appro6 priateness of HCPCS codes selected for auc7 tions. 

8 (B) An evaluation and assessment of the 

9 ability of individuals eligible for the DMEPOS 

10 items subject to the program to obtain these 

11 items and services, including an assessment of 

12 utilization patterns. 

13 (C) An analysis of any current or future 

14 adverse effects on beneficiaries’ health outcomes 

15 related to the program and related costs to the 

16 Medicare trust fund, including an analysis of 

17 those beneficiaries in each competitively bid 

18 area who did not continue to receive such items 

19 and the effect on their Medicare claims under 

20 parts A, B, and D. 

21 (D) An identification and report on the 

22 cause of any material deterioration in the qual23 ity of items and services provided to an indi24 vidual eligible for DMEPOS benefits under the 

25 program. 


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1 (E) An evaluation of the costs of any pre2 ventable or prolonged hospitalizations due to 

3 lack of timely access to items and related serv4 ices subject to the program. 

5 (F) An identification, for each product cat6 egory and competitive bid area in the round 1 

7 re-bid, of the following: 

8 (i) The original winning bidders which 

9 signed contracts and the number of al10 lowed unique Medicare beneficiaries each 

11 contracting supplier fulfilled annually for 

12 the calendar years 2010, 2011 and 2012 in 

13 the competitive bidding areas. 

14 (ii) How many contracting suppliers 

15 failed to submit beneficiary product claims 

16 for more than 60 consecutive days. 

17 (iii) An identification of DMEPOS 

18 suppliers added after January 1, 2011, 

19 and the number of allowed unique Medi20 care beneficiaries each such added supplier 

21 served annually for the calendar years 

22 2010, 2011 and 2012 in the competitive 

23 bidding areas. 


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1 (G) An identification, for each product cat2 egory and each competitive bidding area in the 

3 round 1 re-bid and in round 2, of the following: 

4 (i) The number of winning suppliers. 

5 (ii) The number of such winning sup6 pliers which have not previously supplied 

7 the DMEPOS products bid for in the com8 petitive bidding area. 

9 (iii) The total actual unique Medicare 

10 beneficiaries served by such winning sup11 pliers, for 2010 with the round 1 re-bid 

12 and 2012 for round 2. 

13 (iv) The total capacity, measured by 

14 unique Medicare beneficiaries to be served 

15 by such winning suppliers, as estimated by 

16 Secretary to meet the needs of seniors dur17 ing the contracting period. 

18 (v) Such total capacity as bid by the 

19 winning bidders. 

20 (vi) The total capacity attributed by 

21 the Secretary to the winning bidders. 

22 (3) RECOMMENDATIONS.—Such report shall 

23 also include such recommendations for changes in 

24 such program as the auction expert team determines 

25 appropriate, including recommendations that reVerDate Mar 15 2010 02:47 Jun 21, 2013 Jkt 029200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H2375.IH H2375

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1 spond to all the potential problems identified under 

2 paragraph (2). 

Æ 


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