Under pressure from health plans and the Maryland congressional delegation, HCFA is considering abandoning its plans to run a competitive-bidding demonstration project for Medicare managed-care plans in Baltimore.
However, officials say they are still committed to trying the plan at other, undisclosed sites.
According to Barbara Cooper, HCFA deputy associate administrator for policy, "It's not clear what, if anything, we will do in Baltimore."
But Cooper added that administration officials "still want to do the demonstration, so we are looking at other sites."
Neither Cooper nor Bruce Fried, director of HCFA's managed-care office, would disclose the other sites being considered.
Under the project, all the Baltimore-area managed-care plans were to submit bids for a HCFA-produced standard-benefit package.
All plans that submitted a bid higher than the winning bid would be required to charge beneficiaries a premium equalling the difference between their bid and the rate of the winning bidder.
The plans involved were critical of the proposal, arguing that plans that submitted bids higher than the chosen rate would be severely disadvantaged.
HCFA also had concerns. Among the problems cited by Cooper is Maryland's decision to enroll its Medicaid beneficiaries in managed-care plans, which Cooper said would make it difficult for plans to handle the demonstration project as well.
"It would be hard for them to deal with both," Cooper said. She added that the question HCFA is now trying to decide is, "Is it just a timing issue or should we start somewhere else?"
Maryland congressmen, led by Democratic Rep. Benjamin Cardin, had called on HCFA to delay the start of the project until the problems were addressed.
Last week, Cardin said, "If HCFA does go forward with the project, it will be dramatically different than originally proposed."
Cooper added that whether the proj-ect takes place in Baltimore or another site, it is unlikely that HCFA will meet its original start date of Jan. 1, 1997.