The Centers for Medicare & Medicaid Services (CMS) has announced the next steps in the implementation of the round one rebid of the Medicare competitive bidding program for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS), including the general timeline of fall 2009 for opening the bid window.
“Congress mandated that competition for the round one rebid occur in 2009,” said Charlene Frizzera, CMS acting administrator. “CMS is announcing the next steps to implement the DMEPOS competitive bidding program now to give the supplier community ample time to prepare as well as inform other stakeholders. This program generated substantial savings for Medicare and beneficiaries who used these items and supplies in the competitive bidding areas last summer and is consistent with CMS’ goal to pay appropriately for Medicare items and services.”
CMS will now begin general pre-bidding supplier-awareness and education efforts about key steps suppliers need to take now to be ready for registration and bidding, including getting appropriate state licenses, updating Medicare enrollment files with the National Supplier Clearinghouse, and getting accredited and bonded. A fact sheet about the bidder preparation process is available at www.cms.hhs.gov/apps/media/fact_sheets.asp
On June 4, CMS will convene a meeting of the DMEPOS competitive-bidding Program Advisory and Oversight Committee (PAOC) before announcing the detailed timeline for the program in the summer. The bidder-registration period is expected to begin this summer before bidding opens in the fall. CMS stated that it has “has made a number of process improvements for the round one rebid, such as an upgraded online bid submission system, early bidder education, and increased oversight of bidders that are new to product categories or competitive bidding areas to ensure they meet CMS’ requirements.”
As part of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), Congress enacted a temporary delay of the competitive bidding program and mandated certain changes in the program. The law required CMS to terminate contracts awarded in round one and to conduct the competition for the round one rebid in 2009. Additionally, the new law established a financial-document review process and a requirement that contract suppliers report subcontract relationships with other suppliers. MIPPA also excluded certain DMEPOS items and areas from competitive bidding and provided an exemption to the program for hospitals that furnish certain types of DMEPOS items to their own patients. However, MIPPA did not fundamentally change the nature of the competitive bidding program as established by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) or the existing competitive bidding regulations that were finalized in 2007.
CMS stated that from a beneficiary standpoint, there will be no immediate effect on the Medicare DMEPOS benefit, and Medicare beneficiaries may continue to use their current DMEPOS suppliers at this time.
Round one of the DMEPOS competitive bidding program was implemented on July 1, 2008, in ten competitive bidding areas, as mandated by the MMA. The round one competitive-bidding process resulted in average savings of 26 percent compared to the prices Medicare would have paid for the competitive-bid items under the existing DMEPOS fee schedule in 2008. CMS stated in a press release that these lower prices directly translated to lower out-of-pocket costs for Medicare beneficiaries, who are responsible for 20 percent coinsurance on these items and services after any unmet Part B deductible.
For more information, visit www.cms.hhs.gov/dmeposcompetitivebid/01_overview.asp#topofpage