NEW PROGRAM REDUCES COSTS AND IMPROVES ACCESS TO HIGH QUALITY MEDICAL EQUIPMENT AND SUPPLIES FOR MEDICARE BENEFICIARIES
Today, the Centers for Medicare & Medicaid Services (CMS) issued a final rule to implement a new competitive bidding program in Medicare that will reduce beneficiary out-of-pocket costs, improve the accuracy of Medicare payments, and ensure beneficiary access to high quality medical equipment and supplies.
As health care costs continue to rise, this new program is an opportunity to improve and modernize Medicare, using the competitive marketplace to obtain better value for beneficiaries and taxpayers. It builds upon the success of competitive bidding demonstration projects in Texas and Florida, which produced significant cost savings with uninterrupted beneficiary access to high quality medical items and supplies.
The new competitive bidding program, mandated by Congress in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), will replace the current Medicare fee schedule for certain durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) in ten of the largest Metropolitan Statistical Areas across the country and will apply initially to ten categories of medical equipment and supplies. CMS expects to begin the bidding process in late April, to announce winning suppliers in early December, and to have payments under the program go into effect in April 2008.
Beneficiary and Taxpayer Savings
When fully implemented in 2010, the program is projected to save Medicare and taxpayers $1 billion annually—and these savings will directly translate to lower coinsurance for Medicare beneficiaries. Further, the projected overall savings to part B of the Medicare program should help reduce the part B premium Medicare beneficiaries pay each month.
High Quality Medical Equipment and Supplies
The bidding process is designed to ensure the availability of a wide variety of medical equipment and supplies for beneficiaries. When combined with the supplier quality standards and accreditation requirements that are already underway, this program will ensure that high quality medical equipment and supplies are available to Medicare beneficiaries who need them.
Efficient and Uninterrupted Delivery of Care
The program is designed to be user friendly for Medicare beneficiaries, preserving the physician-patient relationship. By including a limited exception that will allow certain treating professionals to furnish certain specified items on the competitive bidding list to their patients without participating in the bidding process, the program promotes the efficient and uninterrupted delivery of care to Medicare beneficiaries. In addition, when suppliers that furnish home oxygen and other rented durable medical equipment in a competitive bidding area are not awarded contracts under the program, these suppliers and the Medicare beneficiaries they serve will have the opportunity to continue their rental agreements and supply arrangements under the program.
Delivery Choices for Diabetic Supplies
Approximately 60 percent of diabetic supplies (i.e., test strips and lancets used with blood glucose monitors) are currently delivered to Medicare beneficiaries through mail-order arrangements. Under the competitive bidding program, beneficiaries will continue to have the option of obtaining these important supplies through mail-order or other modes of delivery, as only mail-order diabetic supplies are subject to competitive bidding at this time.
If a beneficiary living in a competitive bidding area chooses to obtain these supplies through mail-order, they are expected to reduce their costs for these supplies by obtaining them from one of the suppliers awarded a contract under the competitive bidding program. If the beneficiary chooses to obtain their diabetic supplies from a local pharmacy or supplier storefront or by supplier delivery other than mail delivery, then they can obtain the supplies from any enrolled Medicare supplier and payment for the supplies will be based on the current fee schedule payment methodology.
In no case will a beneficiary’s choice of their blood glucose monitor be affected by the competitive bidding program. The blood glucose monitors are not subject to competitive bidding at this time, and suppliers who furnish replacement test strips through the competitive bidding mail-order program will be required to furnish the same brands of test strips they furnish to non-Medicare patients.
Small Supplier Protections
A number of protections have been included to ensure small supplier participation and access to the competitive bidding market, including establishing a target number for small suppliers equal to 30 percent of the number of winning suppliers in each product category, allowing small suppliers to form networks to participate in the bidding process, and granting small suppliers the flexibility to choose the product categories on which they will submit bids (as suppliers will not be required to submit bids for all product categories).
CHARLOTTE-GASTONIA-CONCORD, NC-SC
This new program changes the way Medicare will pay for certain medical equipment and supplies in select areas of the country, including the Charlotte-Gastonia-Concord, NC-SC metropolitan area.
The Charlotte-Gastonia-Concord, NC-SC metropolitan area was chosen as one of the first areas to benefit from this new program because it is one of the 50 largest metropolitan areas in the country and ranks highly in terms of total Medicare DMEPOS allowed charges, allowed charges per beneficiary, and suppliers per beneficiary.
- The counties to be covered in the Charlotte-Gastonia-Concord, NC-SC metropolitan area for non-mail-order products are Anson, Cabarrus, Gaston, Mecklenburg, and Union Counties in North Carolina and York County in South Carolina. Zip codes that have at least 50 percent of their area in these counties will be covered. The coverage area for mail-order products is slightly larger because all zip codes with any area in these counties will be included. The full list of zip codes that will benefit from the program can be found on the CMS website at http://www.dmecompetitivebid.com.
- Although the program will initially involve ten product categories, not all of these categories will be bid in all areas. The nine categories of items to be bid in the Charlotte-Gastonia-Concord, NC-SC metropolitan area are:
- Oxygen Supplies and Equipment;
o Standard Power Wheelchairs, Scooters, and Related Accessories;
o Complex Rehabilitative Power Wheelchairs and Related Accessories;
o Mail-Order Diabetic Supplies;
o Enteral Nutrients, Equipment, and Supplies;
o Continuous Positive Airway Pressure (CPAP) Devices, Respiratory Assist Devices (RADs), and Related Supplies and Accessories;
o Hospital Beds and Related Accessories;
o Negative Pressure Wound Therapy (NPWT) Pumps and Related Supplies and Accessories; and
o Walkers and Related Accessories.
· The 174,319 eligible beneficiaries residing in the area were served by 279 suppliers in 2005.
· Total Medicare spending for medical equipment and supplies in the Charlotte-Gastonia-Concord, NC-SC metropolitan area was $38 million in 2005.
· Anticipated savings for taxpayers in the Charlotte-Gastonia-Concord, NC-SC metropolitan area during the first full year of the program are about $6.2 million, and beneficiary out-of-pocket costs in the area are projected to decrease by an estimated $1.5 million.
CINCINNATI-MIDDLETOWN, OH-KY-IN
This new program changes the way Medicare will pay for certain medical equipment and supplies in select areas of the country, including the Cincinnati-Middletown, OH-KY-IN metropolitan area.
The Cincinnati-Middletown, OH-KY-IN metropolitan area was chosen as one of the first areas to benefit from this new program because it is one of the 50 largest metropolitan areas in the country and ranks highly in terms of total Medicare DMEPOS allowed charges, allowed charges per beneficiary, and suppliers per beneficiary.
· The counties to be covered in the Cincinnati-Middletown, OH-KY-IN metropolitan area for non-mail-order products are Brown, Butler, Clermont, Hamilton, and Warren Counties in Ohio; Boone, Campbell, and Kenton Counties in Kentucky; and Dearborn County in Indiana. Zip codes that have at least 50 percent of their area in these counties will be covered. The coverage area for mail-order products is slightly larger and also includes Bracken, Gallatin, Grant, and Pendleton Counties in Kentucky and Franklin and Ohio Counties in Indiana. All zip codes with any area in these counties will be covered. The full list of zip codes that will benefit from the program can be found on the CMS website at http://www.dmecompetitivebid.com.
· Although the program will initially involve ten product categories, not all of these categories will be bid in all areas. The nine categories of items to be bid in the Cincinnati-Middletown, OH-KY-IN metropolitan area are:
o Oxygen Supplies and Equipment;
o Standard Power Wheelchairs, Scooters, and Related Accessories;
o Complex Rehabilitative Power Wheelchairs and Related Accessories;
o Mail-Order Diabetic Supplies;
o Enteral Nutrients, Equipment, and Supplies;
o Continuous Positive Airway Pressure (CPAP) Devices, Respiratory Assist Devices (RADs), and Related Supplies and Accessories;
o Hospital Beds and Related Accessories;
o Negative Pressure Wound Therapy (NPWT) Pumps and Related Supplies and Accessories; and
o Walkers and Related Accessories.
· The 251,390 eligible beneficiaries residing in the area were served by 305 suppliers in 2005.
· Total Medicare spending for medical equipment and supplies in the Cincinnati-Middletown, OH-KY-IN metropolitan area was $38 million in 2005.
· Anticipated savings for taxpayers in the Cincinnati-Middletown, OH-KY-IN metropolitan area during the first full year of the program are about $6.1 million, and beneficiary out-of-pocket costs in the area are projected to decrease by an estimated $1.5 million.
CLEVELAND-ELYRIA-MENTOR, OH
This new program changes the way Medicare will pay for certain medical equipment and supplies in select areas of the country, including the Cleveland-Elyria-Mentor, OH metropolitan area.
The Cleveland-Elyria-Mentor, OH metropolitan area was chosen as one of the first areas to benefit from this new program because it is one of the 50 largest metropolitan areas in the country and ranks highly in terms of total Medicare DMEPOS allowed charges, allowed charges per beneficiary, and suppliers per beneficiary.
· The counties to be covered in the Cleveland-Elyria-Mentor, OH metropolitan area for non-mail-order products are Cuyahoga, Geauga, Lake, Lorain, and Medina. Zip codes that have at least 50 percent of their area in these counties will be covered. The coverage area for mail-order products is slightly larger because all zip codes with any area in these counties will be included. The full list of zip codes that will benefit from the program can be found on the CMS website at http://www.dmecompetitivebid.com.
· Although the program will initially involve ten product categories, not all of these categories will be bid in all areas. The nine categories of items to be bid in the Cleveland-Elyria-Mentor, OH metropolitan area are:
o Oxygen Supplies and Equipment;
o Standard Power Wheelchairs, Scooters, and Related Accessories;
o Complex Rehabilitative Power Wheelchairs and Related Accessories;
o Mail-Order Diabetic Supplies;
o Enteral Nutrients, Equipment, and Supplies;
o Continuous Positive Airway Pressure (CPAP) Devices, Respiratory Assist Devices (RADs), and Related Supplies and Accessories;
o Hospital Beds and Related Accessories;
o Negative Pressure Wound Therapy (NPWT) Pumps and Related Supplies and Accessories; and
o Walkers and Related Accessories.
· The 287,511 eligible beneficiaries residing in the area were served by 325 suppliers in 2005.
· Total Medicare spending for medical equipment and supplies in the Cleveland-Elyria-Mentor, OH metropolitan area was $47 million in 2005.
· Anticipated savings for taxpayers in the Cleveland-Elyria-Mentor, OH metropolitan area during the first full year of the program are about $7.6 million, and beneficiary out-of-pocket costs in the area are projected to decrease by an estimated $1.9 million.
DALLAS-FORT WORTH-ARLINGTON, TX
This new program changes the way Medicare will pay for certain medical equipment and supplies in select areas of the country, including the Dallas-Fort Worth-Arlington, TX metropolitan area.
The Dallas-Fort Worth-Arlington, TX metropolitan area was chosen as one of the first areas to benefit from this new program because it is one of the 50 largest metropolitan areas in the country and ranks highly in terms of total Medicare DMEPOS allowed charges, allowed charges per beneficiary, and suppliers per beneficiary.
· The counties to be covered in the Dallas-Fort Worth-Arlington, TX metropolitan area for non-mail-order products are Collin, Dallas, Denton, Ellis, Hunt, Johnson, Kaufman, Parker, Rockwall, Tarrant, and Wise. Zip codes that have at least 50 percent of their area in these counties will be covered. The coverage area for mail-order products is slightly larger because all zip codes with any area in these counties will be included; Delta County is also included. The full list of zip codes that will benefit from the program can be found on the CMS website at http://www.dmecompetitivebid.com.
· Although the program will initially involve ten product categories, not all of these categories will be bid in all areas. The nine categories of items to be bid in the Dallas-Fort Worth-Arlington, TX metropolitan area are:
o Oxygen Supplies and Equipment;
o Standard Power Wheelchairs, Scooters, and Related Accessories;
o Complex Rehabilitative Power Wheelchairs and Related Accessories;
o Mail-Order Diabetic Supplies;
o Enteral Nutrients, Equipment, and Supplies;
o Continuous Positive Airway Pressure (CPAP) Devices, Respiratory Assist Devices (RADs), and Related Supplies and Accessories;
o Hospital Beds and Related Accessories;
o Negative Pressure Wound Therapy (NPWT) Pumps and Related Supplies and Accessories; and
o Walkers and Related Accessories.
· The 481,835 eligible beneficiaries residing in the area were served by 580 suppliers in 2005.
· Total Medicare spending for medical equipment and supplies in the Dallas-Fort Worth-Arlington, TX metropolitan area was $101 million in 2005.
· Anticipated savings for taxpayers in the Dallas-Fort Worth-Arlington, TX metropolitan area during the first full year of the program are about $16.2 million, and beneficiary out-of-pocket costs in the area are projected to decrease by an estimated $4.1 million.
KANSAS CITY, MO-KS
This new program changes the way Medicare will pay for certain medical equipment and supplies in select areas of the country, including the Kansas City, MO-KS metropolitan area.
The Kansas City, MO-KS metropolitan area was chosen as one of the first areas to benefit from this new program because it is one of the 50 largest metropolitan areas in the country and ranks highly in terms of total Medicare DMEPOS allowed charges, allowed charges per beneficiary, and suppliers per beneficiary.
· The counties to be covered in the Kansas City, MO-KS metropolitan area for non-mail-order products are Cass, Clay, Jackson, Lafayette, Platte, and Ray Counties in Missouri and Franklin, Johnson, Leavenworth, Miami, and Wyandotte Counties in Kansas. Zip codes that have at least 50 percent of their area in these counties will be covered. The coverage area for mail-order products is slightly larger, and also includes Bates, Caldwell, and Clinton Counties in Missouri and Linn County in Kansas. All zip codes in these counties will be covered. The full list of zip codes that will benefit from the program can be found on the CMS website at http://www.dmecompetitivebid.com.
· Although the program will initially involve ten product categories, not all of these categories will be bid in all areas. The nine categories of items to be bid in the Kansas City, MO-KS metropolitan area are:
o Oxygen Supplies and Equipment;
o Standard Power Wheelchairs, Scooters, and Related Accessories;
o Complex Rehabilitative Power Wheelchairs and Related Accessories;
o Mail-Order Diabetic Supplies;
o Enteral Nutrients, Equipment, and Supplies;
o Continuous Positive Airway Pressure (CPAP) Devices, Respiratory Assist Devices (RADs), and Related Supplies and Accessories;
o Hospital Beds and Related Accessories;
o Negative Pressure Wound Therapy (NPWT) Pumps and Related Supplies and Accessories; and
o Walkers and Related Accessories.
· The 225,481 eligible beneficiaries residing in the area were served by 248 suppliers in 2005.
· Total Medicare spending for medical equipment and supplies in the Kansas City, MO-KS metropolitan area was $40 million in 2005.
· Anticipated savings for taxpayers in the Kansas City, MO-KS metropolitan area during the first full year of the program are about $6.4 million, and beneficiary out-of-pocket costs in the area are projected to decrease by an estimated $1.6 million.
MIAMI-FORT LAUDERDALE-MIAMI BEACH, FL
This new program changes the way Medicare will pay for certain medical equipment and supplies in select areas of the country, including the Miami-Fort Lauderdale-Miami Beach, FL metropolitan area.
The Miami-Fort Lauderdale-Miami Beach, FL metropolitan area was chosen as one of the first areas to benefit from this new program because it is one of the 50 largest metropolitan areas in the country and ranks highly in terms of total Medicare DMEPOS allowed charges, allowed charges per beneficiary, and suppliers per beneficiary.
· The counties to be covered in the Miami-Fort Lauderdale-Miami Beach, FL metropolitan area for non-mail-order products are Broward, Miami-Dade, and Palm Beach. Zip codes that have at least 50 percent of their area in these counties will be covered. The coverage area for mail-order products is slightly larger because all zip codes with any area in these counties will be included. The full list of zip codes that will benefit from the program can be found on the CMS website at http://www.dmecompetitivebid.com.
· The ten categories of items to be bid in the Miami-Fort Lauderdale-Miami Beach, FL metropolitan area are:
o Oxygen Supplies and Equipment;
o Standard Power Wheelchairs, Scooters, and Related Accessories;
o Complex Rehabilitative Power Wheelchairs and Related Accessories;
o Mail-Order Diabetic Supplies;
o Enteral Nutrients, Equipment, and Supplies;
o Continuous Positive Airway Pressure (CPAP) Devices, Respiratory Assist Devices (RADs), and Related Supplies and Accessories;
o Hospital Beds and Related Accessories;
o Negative Pressure Wound Therapy (NPWT) Pumps and Related Supplies and Accessories;
o Walkers and Related Accessories; and
o Support Surfaces (Group 2 and 3 mattresses and overlays).
· The 514,523 eligible beneficiaries residing in the area were served by 1,275 suppliers in 2005.
· Total Medicare spending for medical equipment and supplies in the Miami-Fort Lauderdale-Miami Beach, FL metropolitan area was $192 million in 2005.
· Anticipated savings for taxpayers in Miami-Fort Lauderdale-Miami Beach, FL during the first full year of the program are about $30.6 million, and beneficiary out-of-pocket costs in the area are projected to decrease by an estimated $7.7 million.
ORLANDO-KISSIMMEE, FL
This new program changes the way Medicare will pay for certain medical equipment and supplies in select areas of the country, including the Orlando-Kissimmee, FL metropolitan area.
The Orlando-Kissimmee, FL metropolitan area was chosen as one of the first areas to benefit from this new program because it is one of the 50 largest metropolitan areas in the country and ranks highly in terms of total Medicare DMEPOS allowed charges, allowed charges per beneficiary, and suppliers per beneficiary.
· The counties to be covered in the Orlando-Kissimmee, FL metropolitan area for non-mail-order products are Lake, Orange, Osceola, and Seminole. Zip codes that have at least 50 percent of their area in these counties will be covered. The coverage area for mail-order products is slightly larger because all zip codes with any area in these counties will be included. The full list of zip codes that will benefit from the program can be found on the CMS website at http://www.dmecompetitivebid.com.
· Although the program will initially involve ten product categories, not all of these categories will be bid in all areas. The nine categories of items to be bid in the Orlando-Kissimmee, FL metropolitan area are:
o Oxygen Supplies and Equipment;
o Standard Power Wheelchairs, Scooters, and Related Accessories;
o Complex Rehabilitative Power Wheelchairs and Related Accessories;
o Mail-Order Diabetic Supplies;
o Enteral Nutrients, Equipment, and Supplies;
o Continuous Positive Airway Pressure (CPAP) Devices, Respiratory Assist Devices (RADs), and Related Supplies and Accessories;
o Hospital Beds and Related Accessories;
o Negative Pressure Wound Therapy (NPWT) Pumps and Related Supplies and Accessories; and
o Walkers and Related Accessories.
· The 246,880 eligible beneficiaries residing in the area were served by 331 suppliers in 2005.
· Total Medicare spending for medical equipment and supplies in the Orlando-Kissimmee, FL metropolitan area was $49 million in 2005.
· Anticipated savings for taxpayers in the Orlando-Kissimmee, FL metropolitan area during the first full year of the program are about $7.8 million, and beneficiary out-of-pocket costs in the area are projected to decrease by an estimated $2 million.
PITTSBURGH, PA
This new program changes the way Medicare will pay for certain medical equipment and supplies in select areas of the country, including the Pittsburgh, PA metropolitan area.
The Pittsburgh, PA metropolitan area was chosen as one of the first areas to benefit from this new program because it is one of the 50 largest metropolitan areas in the country and ranks highly in terms of total Medicare DMEPOS allowed charges, allowed charges per beneficiary, and suppliers per beneficiary.
· The counties to be covered in Pittsburgh, PA for non-mail-order products are Allegheny, Armstrong, Beaver, Butler, Fayette, Washington, and Westmoreland. Zip codes that have at least 50 percent of their area in these counties will be covered. The coverage area for mail-order products is slightly larger because all zip codes with any area in these counties will be included. The full list of zip codes that will benefit from the program can be found on the CMS website at http://www.dmecompetitivebid.com.
· Although the program will initially involve ten product categories, not all of these categories will be bid in all areas. The nine categories of items to be bid in the Pittsburgh, PA metropolitan area are:
o Oxygen Supplies and Equipment;
o Standard Power Wheelchairs, Scooters, and Related Accessories;
o Complex Rehabilitative Power Wheelchairs and Related Accessories;
o Mail-Order Diabetic Supplies;
o Enteral Nutrients, Equipment, and Supplies;
o Continuous Positive Airway Pressure (CPAP) Devices, Respiratory Assist Devices (RADs), and Related Supplies and Accessories;
o Hospital Beds and Related Accessories;
o Negative Pressure Wound Therapy (NPWT) Pumps and Related Supplies and Accessories; and
o Walkers and Related Accessories.
· The 265,608 eligible beneficiaries residing in the area were served by 289 suppliers in 2005.
· Total Medicare spending for medical equipment and supplies in the Pittsburgh, PA metropolitan area was $47 million in 2005.
· Anticipated savings for taxpayers in the Pittsburgh, PA metropolitan area during the first full year of the program are about $7.5 million, and beneficiary out-of-pocket costs in the area are projected to decrease by an estimated $1.9 million.
RIVERSIDE-SAN BERNARDINO-ONTARIO, CA
This new program changes the way Medicare will pay for certain medical equipment and supplies in select areas of the country, including the Riverside-San Bernardino-Ontario, CA metropolitan area.
The Riverside-San Bernardino-Ontario, CA metropolitan area was chosen as one of the first areas to benefit from this new program because it is one of the 50 largest metropolitan areas in the country and ranks highly in terms of total Medicare DMEPOS allowed charges, allowed charges per beneficiary, and suppliers per beneficiary.
· The counties to be covered in the Riverside-San Bernardino-Ontario, CA metropolitan area for non-mail-order products include densely populated zip codes in the western part of Riverside County and the southwestern region of San Bernardino. San Bernardino is the largest county in the contiguous 48 states and Riverside is also very large. Both counties include sparsely populated areas in the mountains and desert. These areas are not included in the competitive bidding area for non-mail-order products because they have low population and allowed charges, are predominantly rural, are geographically distant from the center of the competitive bidding area, and are served by few suppliers. However, because mail-order products can be delivered anywhere, the coverage area for mail-order products includes all areas in Riverside and San Bernardino Counties. The full list of zip codes that will benefit from the program can be found on the CMS website at http://www.dmecompetitivebid.com.
· Although the program will initially involve ten product categories, not all of these categories will be bid in all areas. The nine categories of items to be bid in the Riverside-San Bernardino-Ontario, CA metropolitan area are:
o Oxygen Supplies and Equipment;
o Standard Power Wheelchairs, Scooters, and Related Accessories;
o Complex Rehabilitative Power Wheelchairs and Related Accessories;
o Mail-Order Diabetic Supplies;
o Enteral Nutrients, Equipment, and Supplies;
o Continuous Positive Airway Pressure (CPAP) Devices, Respiratory Assist Devices (RADs), and Related Supplies and Accessories;
o Hospital Beds and Related Accessories;
o Negative Pressure Wound Therapy (NPWT) Pumps and Related Supplies and Accessories; and
o Walkers and Related Accessories.
· The 248,766 eligible beneficiaries residing in the area were served by 495 suppliers in 2005.
· Total Medicare spending for medical equipment and supplies in the Riverside-San Bernardino-Ontario, CA metropolitan area was $42 million in 2005.
· Anticipated savings for taxpayers in the Riverside-San Bernardino-Ontario, CA metropolitan area during the first full year of the program are about $6.8 million, and beneficiary out-of-pocket costs in the area are projected to decrease by an estimated $1.7 million.
SAN JUAN-CAGUAS-GUAYNABO, PR
This new program changes the way Medicare will pay for certain medical equipment and supplies in select areas of the country, including the San Juan-Caguas-Guaynabo, PR metropolitan area.
The San Juan-Caguas-Guaynabo, PR metropolitan area was chosen as one of the first areas to benefit from this new program because it is one of the 50 largest metropolitan areas in the country and ranks highly in terms of total Medicare DMEPOS allowed charges, allowed charges per beneficiary, and suppliers per beneficiary.
· The municipios to be covered in the San Juan-Caguas-Guaynabo, PR metropolitan area for non-mail-order products are Aguas Buenas, Aibonito, Arecibo, Barceloneta, Barranquitas, Bayamón, Caguas, Camuy, Canóvanas, Carolina, Cataño, Cayey, Ciales, Cidra, Comerío, Corozal, Dorado, Florida, Guaynabo, Gurabo, Hatillo, Humacao, Juncos, Las Piedras, Loíza, Manatí, Maunabo, Morovis, Naguabo, Naranjito, Orocovis, Quebradillas, Río Grande, San Juan, San Lorenzo, Toa Alta, Toa Baja, Trujillo Alto, Vega Alta, Vega Baja, and Yabucoa. The coverage area for mail-order products is identical. The full list of zip codes that will benefit from the program can be found on the CMS website at http://www.dmecompetitivebid.com.
· The ten categories of items to be bid in the San Juan-Caguas-Guaynabo, PR metropolitan area are:
o Oxygen Supplies and Equipment;
o Standard Power Wheelchairs, Scooters, and Related Accessories;
o Complex Rehabilitative Power Wheelchairs and Related Accessories;
o Mail-Order Diabetic Supplies;
o Enteral Nutrients, Equipment, and Supplies;
o Continuous Positive Airway Pressure (CPAP) Devices, Respiratory Assist Devices (RADs), and Related Supplies and Accessories;
o Hospital Beds and Related Accessories;
o Negative Pressure Wound Therapy (NPWT) Pumps and Related Supplies and Accessories;
o Walkers and Related Accessories; and
o Support Surfaces (Group 2 and 3 mattresses and overlays).
· The 297,950 eligible beneficiaries residing in the area were served by 402 suppliers in 2005.
· Total Medicare spending for medical equipment and supplies in the San Juan-Caguas-Guaynabo, PR metropolitan area was $60 million in 2005.
· Anticipated savings for taxpayers in the San Juan-Caguas-Guaynabo, PR metropolitan area during the first full year of the program are about $9.6 million, and beneficiary out-of-pocket costs in the area are projected to decrease by an estimated $2.4 million.