Another chaotic month has come and gone, with competitive bidding and accreditation once again dominating headlines. As a journalist on the HME beat, it makes for an exciting day and plenty of grist for the news mill. However, I suspect that most HME Today readers would prefer quiet stability. As Richard Pennington, vice president of Alliance Medical, Ontario, Calif, told me on the phone today, "Quiet stability is not going to happen any time soon."

Pennington is one of the unfortunate guinea pigs to be caught up in the first round of competitive bidding. Like many providers, CMS rejected Pennington's bid because he supposedly lacked appropriate "financials" with his bidding paperwork. In response, Pennington went into his records and found something distinctly odd. CMS issued its original request for bid (RFB) on May 31, 2007, but Pennington found they later changed the rules—without telling providers or members of Congress.

Pennington found the discrepancy by comparing his original hard copies to the current RFB rules on the Competitive Bidding Implementation Contractor (CBIC) Web site. In the original document, on page 2 of the RFB, CMS had the following line: "beginning 10 business days before the bidding window ends, suppliers will be notified if there are any missing hard copy attachments."

On September 13, 2007, a short time before the bidding window closed on September 25, page 2 was altered. "When you go to the Web site now, and you look for the RFBs, this original has been removed and it has been replaced," says Pennington. "The second page is revised. When you look at that second page, item #4 has been stricken. Now #4 says, ‘The system will remain open for at least 15 days after the bidding window ends to allow bidders to check the completion status of their electronic bids and verify receipt of hard copy documents by the CBIC.' "

When I reported this last month in our weekly electronic newsletter, Friday Report, it felt like one more straw on the camel's back. Ultimately, this bizarre find was more fuel for the fire that has included legal threats (AAHomecare retained a law firm) and letters from several different lawmakers to HHS Secretary Michael Leavitt. As I write this, yet another letter from Sen George Voinovich (and signed by an additional seven senators) has asked Leavitt to sit down and discuss competitive bidding. "The letter is asking for the meeting," says John Gallagher, vice president of government relations for VGM and Associates, Waterloo, Iowa. "In many ways it's the equivalent to taking the HHS Secretary to the woodshed."

It's been exactly 4 years since I took over the editor's job at HME Today, and there have been several of these woodshed moments (and watershed moments for that matter), but I have never seen the intensity we're seeing now. Four years ago, competitive bidding was but a whisper. Now AAHomecare is planning yet another Washington, DC fly-in for May 21. If the rest of the industry continues to pile on the pressure in advance of this event, HME providers could get that delay, or even a reassessment. Time and effort will tell.

Greg Thompson