The Centers for Medicare & Medicaid Services (CMS) is seeking public comment as it moves toward nationwide implementation of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. The deadline to submit comments is March 28.
The Competitive Bidding Program, established by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Medicare Modernization Act or MMA). Under the program, DMEPOS suppliers compete to become Medicare contract suppliers by submitting bids to furnish certain items in competitive bidding areas. The new, lower payment amounts resulting from the competition replace the fee schedule amounts for the bid items in these areas. By 2016, Medicare must implement competitive bidding or competitive bidding pricing for included items to noncompetitive bidding areas.
To this extent, CMS is requesting public comments on the methodology it would use to adjust DMEPOS fee schedule amounts or other payment amounts in noncompetitive areas based on DMEPOS competitive bidding payment information. CMS is seeking input in several areas, including:
- Do the costs of furnishing various DMEPOS items and services vary based on the geographic area in which they are furnished?
- Do the costs of furnishing various DMEPOS items and services vary based on the size of the market served in terms of population and/or distance covered or other logistical or demographic reasons?
- Should an interim or different methodology be used to adjust payment amounts for items that have not yet been included in all competitive bidding programs (for example, items such as transcutaneous electrical nerve stimulation (TENS) devices that have only been phased into the nine Round 1 areas thus far)?
CMS is also seeking comments on whether it should consider simplifying the payment rules under competitive bidding programs for certain durable medical equipment (DME) by making one monthly payment to the supplier for all related items and services needed each month. The monthly payments would continue as long as medical necessity for the covered items continued, and the supplier would be responsible for furnishing all items and services needed each month. CMS is seeking input in several areas, including:
- Are lump sum purchases and capped rental payment rules for DME still needed?
- Are there reasons why beneficiaries need to own expensive DME?
- Would there be any negative impacts associated with continuous bundled monthly payments?
The complete announcement, along with information on how to submit comments, was published in the Federal Register on February 26.