During hearings in front of the House Ways and Means subcommittee this week, Rep Pete Stark (D-Calif) [pictured] said of competitive bidding, “The system is somewhere between flawed and lousy.” The comments began a week of renewed discussions on Capitol Hill, and at Medtrade, that cast a harsh spotlight on competitive bidding.

For AAHomecare Chairman Alan Landauer, the week started at Medtrade in Long Beach, Calif, until events quickly brought him back to Capitol Hill for a meeting today (Thursday) with ways and means staffers. “AAHomecare chairman Alan Landauer is leaving here for a meeting up on the Hill tomorrow coming out of yesterday’s [Stark] hearing to discuss options for going in a different direction than competitive bidding,” said Tyler Wilson, president of AAHomecare, during a legislative update Wednesday at this week’s Medtrade (pictured below). Wilson did not elaborate on the exact nature of the meeting.

By all accounts, this week’s Stark hearing was a terse discussion in which CMS Acting Administrator Kerry Weems gave no ground as he endured pointed questions from combative members of Congress. Weems’ testimony focused on cost savings and education programs with charts and graphs included in his presentation. Members of the Subcommittee asked about problems with the program such as the disqualification of 63% of bidders in round one, choosing median pricing rather than lowest pricing, and not allowing willing providers to supply products at the lowest price.

Stark himself asked how the prices were chosen from the bids. As Weems explained that median prices were determined to be the best choice, Stark expressed concern that this was price setting, saying “Sounds like you’re price setting to me. Sometimes you’re bidding, sometimes you’re not. It’s at your convenience.” When Stark asked what CMS had learned from round one of bidding and what they might change in round two, Weems said, “I can’t think of anything I would change.” Stark ended his questioning by saying, “I think I’ve seen you’re a useless witness.”

Additional questions from panelists included, “Why not more bids?” and “Would a 60-day delay to explore issues from round one help?” Members also asked about subcontracting and clarified that subcontractors do not have to be accredited until September of 2009, although Weems said it would be a “bad business decision” on the part of the contract winner to enter into a relationship with a non-accredited company. “It’s a great example of how a hearing can work to the advantage of the industry,” said Tyler Wilson in his remarks at Medtrade. “We got the information ahead of time to our allies on the committee. We had a lot of high-level concern and interest on this issue. And then there was the striking sort of bungling on the part of CMS to march up there and make no concession.

“So they [CMS] kind of backed themselves into a corner, and all to the advantage of this industry and our concerns about competitive bidding,” added Wilson. “The upshot is going to be that you have Stark and Mr. Rangel [Rep Charles B. Rangel (D-NY)] and a number of important people on the full committee rethinking competitive bidding.”

Additional panelists at the Stark hearing included Tom Ryan, past chairman of AAHomecare and CEO of Homecare Concepts. “This Medicare bidding program is a train wreck,” said Ryan. “But as this program jumps off the tracks, the attitude of CMS is clearly ‘full steam ahead.’” Ryan called for an immediate halt to the program and told the subcommittee that a “wide range of problems and questions about the program must be independently evaluated, and an alternative process to determine payment rates for home medical equipment must be explored.”