The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), enacted on July 15, 2008, made limited changes to the Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program, including a requirement that competition to re-bid Round One occur in 2009. Suppliers wishing to participate in the Round One Rebid of the Medicare DMEPOS Competitive Bidding Program, including suppliers that were awarded contracts in the first Round One which occurred in 2007, must register and submit a new bid application for the Round One Rebid competition.
To ensure that suppliers have ample time to prepare for the bidding process, CMS began a pre-bidding supplier awareness campaign in May 2009. CMS has now announced the timeline for bidding and is beginning a comprehensive supplier education campaign leading up to the bidding period.
Suppliers can get information about the competitive bidding program by going to www.dmecomptitive bid.com or by calling the toll-free help desk at 1-877-577-5331.
The Medicare DMEPOS Competitive Bidding Program was established by the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (“Medicare Modernization Act” or “MMA”) to provide important benefits to Medicare beneficiaries and taxpayers, including lowering out-of-pocket costs and generating savings for the Medicare program. Under this program, bids submitted by DMEPOS suppliers are evaluated so that suppliers awarded contracts will ensure access to certain DMEPOS items and services and enhance quality and customer service for Medicare beneficiaries. CMS uses the bids to establish payment amounts for competitively bid DMEPOS items in competitive bidding areas.
Under the MMA, DMEPOS competitive bidding programs were to be phased into the Medicare program so that competition under the program was to occur in 10 areas in 2007. Consistent with the statutory mandate, CMS conducted the Round One competition in 10 competitive bidding areas and 10 product categories of DMEPOS and successfully implemented the program on July 1, 2008. The program’s single payment amounts resulted in a projected savings of approximately 26 percent compared to the traditional Medicare fee schedule. This indicated substantial savings for Medicare beneficiaries and taxpayers.
MIPPA delayed the program and terminated the competitive bidding contracts that were awarded following the Round One competition. As a result, payment for competitively bid items and services was effectively reinstated to the Medicare fee schedule amount.
On January 16, 2009, CMS released an interim final rule that implements certain provisions of MIPPA that affect the Round One Rebid of the Medicare DMEPOS Competitive Bidding Program and includes:
The announcement of the Competitive Bidding Program delay:
- MIPPA delayed the competitions for Rounds One and Two from 2007 and 2009 to 2009 and 2011, respectively;
- Competition in additional areas is delayed until after 2011;
- Competition for a national mail order program for beneficiaries who choose to have certain items shipped directly to their homes is delayed until after 2010;
- The exclusion of negative pressure wound therapy as a competitively bid item and Puerto Rico as an area in the 2009 Round One Rebid;
- The exclusion of group 3 complex rehabilitative power wheelchairs from the competitive bidding program;
- The financial document review process, otherwise known as the covered document review process, to identify certain missing financial documents from the bid submission;
- The requirement for contract suppliers to disclose to CMS subcontracting relationships; and
- An exemption from the program for hospitals, similar to the exemption for physicians and non-physician practitioners, furnishing certain durable medical equipment.
BIDDING TIMELINE FOR THE DMEPOS COMPETITIVE BIDDING PROGRAM
CMS has announced the following bidding timeline for the program:
- CMS BEGINS BIDDER EDUCATION CAMPAIGN
- BIDDER REGISTRATION PERIOD TO OBTAIN USER IDS
AND PASSWORDS BEGINS
- SUPPLIER ACCREDITATION DEADLINE (September 30, 2009)
- SUPPLIER SURETY BOND DEADLINE (October 2, 2009)
- BIDDER REGISTRATION PERIOD ENDS
- 60-DAY SUPPLIER BID WINDOW OPENS
- BIDDING ENDS
- REVIEW BIDS, FINALIZE CONTRACTS, EDUCATE SUPPLIERS, PROVIDERS AND BENEFICIARIES
- DMEPOS COMPETITIVE BIDDING PROGRAM BEGINS FOR BENEFICIARIES
BIDDER EDUCATION EFFORT
CMS is employing an intensive education effort designed to ensure that DMEPOS suppliers interested in bidding get all the information they need to submit a complete bid in a timely manner. CMS will focus initially on preparing suppliers for the registration period. As suppliers get registered for the competitive bidding process, CMS education and outreach efforts will intensify with particular focus on information specific to registered bidders and the bidding process.
The CMS Competitive Bidding Implementation Contractor (CBIC) will be the focal point for bidder education. The CBIC has a dedicated Web site, www.dmecompetitivebid.com, which will include a comprehensive array of important information for suppliers, including bidding rules, user guides, frequently asked questions, policy fact sheets, checklists, and bidding information charts.
The CBIC toll-free help desk can be reached by calling 1-877-577-5331 and is now open to help bidders with all of their questions and concerns.
CMS will send listserv announcements in order to disseminate key information about registration and bidding to suppliers and encourages all suppliers interested in bidding to visit the CBIC Web site now to sign up to receive these announcements.
CMS will hold eight bidders’ conferences, during which various parts of the bidding process will be explained. All of the bidders’ conferences will be held via teleconference to ensure maximum opportunities for suppliers to participate. The schedule for the bidders’ conferences is available on the CBIC web site at www.dmecompetitivebid.com.
IMPORTANT REMINDERS FOR SUPPLIERS INTERESTED IN BIDDING
As in the first Round One program, suppliers must meet all applicable eligibility, financial, quality, and accreditation standards in order to be awarded a contract. Suppliers interested in bidding should prepare now by ensuring that their enrollment files at the National Supplier Clearinghouse (NSC) are up-to-date and that they obtain all required state licenses for the items, and in the areas, for which they wish to bid.
In addition, CMS is reminding DMEPOS suppliers again that time is running out to obtain accreditation by the September 30, 2009 deadline or risk having their Medicare Part B billing privileges revoked on October 1, 2009. Accreditation takes an average of 6 months to complete.
It is very important for DMEPOS suppliers to contact an accreditation organization right away to obtain information about the accreditation process and submit an application. Suppliers must be accredited for a product category in order to submit a bid for that product category. CMS cannot contract with suppliers that are not accredited by a CMS-deemed accreditation organization. Further information on the DMEPOS accreditation requirements, along with a list of the accreditation organizations and those professionals and other persons exempted from accreditation, may be found on the CMS Web site at: http://www.cms.hhs.gov/MedicareProviderSupEnroll/01_Overview.asp.
Certain suppliers will need to obtain and submit a surety bond to the NSC by the October 2, 2009 deadline or risk having their Medicare Part B billing privileges revoked. Suppliers subject to the bonding requirement must be bonded in order to bid in the DMEPOS competitive bidding program. A list of sureties from which a bond can be secured is found at the Department of the Treasury’s “List of Certified (Surety Bond) Companies” and the Web site is located at: www.fms.treas.gov/c570/c570_a-z.html.
ROUND ONE REBID AREAS AND PRODUCT CATEGORIES
The Round One Rebid will occur in the following MSAs (same as the first Round One except Puerto Rico is excluded):
• Cincinnati – Middletown (Ohio , Kentucky and Indiana )
• Cleveland – Elyria – Mentor (Ohio )
• Charlotte – Gastonia – Concord (North Carolina and South Carolina )
• Dallas – Fort Worth – Arlington (Texas )
• Kansas City (Missouri and Kansas )
• Miami – Fort Lauderdale – Miami Beach (Florida )
• Orlando (Florida)
• Pittsburgh (Pennsylvania)
• Riverside – San Bernardino – Ontario (California)
The Round One Rebid will include the following items (same as the first Round One except negative pressure wound therapy items and group 3 complex rehabilitative power wheelchairs are excluded):
• Oxygen and Oxygen Equipment
• Standard Power Wheelchairs, Scooters, and Related Accessories
• Complex Rehabilitative Power Wheelchairs and Related Accessories (Group 2 only)
• Mail-Order Replacement Diabetic Supplies
• Enteral Nutrients, Equipment and Supplies
• Continuous Positive Airway Pressure (CPAP) machines, Respiratory Assist Devices (RADs), and Related Supplies and Accessories
• Hospital Beds and Related Accessories
• Walkers and Related Accessories
• Support Surfaces (Group 2 mattresses and overlays) (in Miami only)
For additional information about the Medicare DMEPOS Competitive Bidding Program, please visit: http://www.cms.hhs.gov/DMEPOSCompetitiveBid/.
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