The Centers for Medicare & Medicaid Services (CMS) has announced plans to expand the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program.
The first phase of the program was implemented for nine product categories in nine areas of the country on January 1, 2011. As required by law, CMS will conduct the second phase of the program for a similar set of products in 91 major metropolitan areas.
In Round 2, CMS is expanding the list of items bid in the Round 1 rebid by combining standard manual wheelchairs, standard power wheelchairs, and scooters to form a new expanded standard mobility device product category, expanding bidding for support surfaces throughout all Round 2 areas, and adding negative pressure wound therapy pumps and related supplies and accessories as an additional product category. According to CMS, all of the product categories selected for Round 2 are high-cost, high-volume items with a large savings potential. Group 2 complex rehabilitative power wheelchairs, which were bid in the Round 1 rebid, will not be included in Round 2 as CMS evaluates the suitability of this product category under the program.
The Round 2 product categories are:
- Oxygen, oxygen equipment, and supplies.
- Standard (power and manual) wheelchairs, scooters, and related accessories.
- Enteral nutrients, equipment, and supplies.
- Continuous positive airway pressure (CPAP) devices and respiratory assist devices (RADs) and related supplies and accessories.
- Hospital beds and related accessories.
- Walkers and related accessories.
- Negative pressure wound therapy pumps and related supplies and accessories.
- Support surfaces (Group 2 mattresses and overlays).
CMS will also be conducting a national mail order competition for diabetic testing supplies at the same time as the Round 2 competition, which will include the 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, and American Samoa.
As with Round 1, orthotics and prosthetics are essentially exempted from the current competitive bidding program, and competitive bidding is not being applied to off-the-shelf orthotics.
A list of the specific items in each product category and a list of the specific ZIP codes in each competitive bidding area (CBA)is available on the Competitive Bidding Implementation Contractor (CBIC) website, www.dmecompetitivebid.com
From a beneficiary standpoint, there will be no immediate effect in areas where the program is expanding. These beneficiaries may continue to use their current suppliers at this time. Similar to the implementation of Round 1 of the program, CMS will conduct extensive outreach to beneficiaries in the Round 2 areas prior to the new program taking effect.
Competition begins this fall, and the new prices will be in effect on July 1, 2013.
To ensure that suppliers have ample time to prepare, CMS has announced the following next steps for the program:
Summer 2011
- CMS begins pre-bidding supplier awareness program.
Fall 2011
- CMS announces bidding schedule.
- CMS begins bidder education program.
- Bidder registration period to obtain user ID and passwords begins.
Winter 2012
- Bidding begins.
CMS has also made the following suggestions:
- Suppliers wishing to bid in Round 2 or the national mail order competition should now begin to get ready for the competition, which will begin with registration this fall. All potential bidders, including suppliers that bid in the Round 1 rebid, will need to register for user IDs and passwords so that they will be able to submit bids. As in the Round 1 rebid program, suppliers must meet all applicable eligibility, financial, quality, and accreditation standards in order to be awarded a contract.
- Suppliers interested in bidding must ensure that certain key information in their enrollment files at the National Supplier Clearinghouse (NSC) is current and that they obtain all required state licenses for the items and in the areas, for which they wish to bid. Any required licenses not already on file with the NSC should be submitted right away.
- Suppliers that are interested in bidding on items they do not currently offer should act now to become accredited for those items. Suppliers must be accredited for all items in a product category to bid for that product category.
More information on the DMEPOS accreditation requirements can be found on the Medicare Provider-Supplier Enrollment webpage. A list of the Round 2 metropolitan statistical areas (MSAs), as well as additional information about the Medicare DMEPOS Competitive Bidding Program, is available on the CMS website at www.cms.gov/DMEPOSCompetitiveBid
