Timeline for the DMEPOS Competitive Bidding Round 1 2017 Competition
Timeline for the DMEPOS Competitive Bidding Round 1 2017 Competition; Beginning of Bidder Education Program
The Centers for Medicare & Medicaid Services (CMS) today announced the bidding timeline for the Round 1 2017 competition of the Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program, as required by law. CMS has also launched a comprehensive bidder education program. This program is designed to ensure that DMEPOS suppliers interested in bidding receive the information and assistance they need to submit complete bids in a timely manner.
The Medicare DMEPOS Competitive Bidding Program has saved more than $580 million in nine markets during the Round 1 Rebid’s 3-year contract period due to lower payments and decreased unnecessary utilization. Additional savings are being achieved as part of the Affordable Care Act’s expansion of the competitive bidding program; in the first year of Round 2 and the national mail-order program, Medicare has saved approximately $2 billion. Furthermore, the monitoring data show that the implementation is going smoothly, with few beneficiary inquiries or complaints and no changes to beneficiary health outcomes. CMS’ Health Status Monitoring has indicated that beneficiaries’ access to necessary and appropriate items and supplies has been preserved. Moreover, the rate of use of hospital services, emergency room visits, physician visits, and skilled nursing facility care has remained consistent with the patterns and trends seen in non-competitive bidding areas.
The Medicare DMEPOS Competitive Bidding Program was established by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 as a way to help Medicare set appropriate payment rates for DMEPOS items and services. The program was expanded by the Affordable Care Act in 2010. In January 2011, Medicare started the program in nine areas of the country, called the Round 1 Rebid. In July 2013, Medicare expanded the competitive bidding program to more areas of the country, called the Round 2 areas, and also implemented a national mail-order program for diabetic testing supplies. And, in January 2014, Medicare continued the program in the original nine areas under the Round 1 Recompete.
The program replaces the outdated, inflated fee-schedule prices Medicare paid for these items with lower, more accurate prices to help Medicare and its beneficiaries save money while ensuring access to quality equipment, supplies and services. It also helps limit fraud and abuse in the Medicare Program.
CMS is required by section 1847(b)(3)(B) of the Social Security Act to recompete contracts under the DMEPOS Competitive Bidding Program at least once every three years. Suppliers compete to become a Medicare contract supplier by submitting bids to provide certain items in competitive bidding areas (CBAs). The payment amounts resulting from the competitions replace the fee schedule amounts for the bid items in these areas.
Round 1 2017 includes seven product categories. CMS will bid the same items as were bid in the Round 1 Recompete with the exception of the external infusion pumps and supplies product category, which is not included in Round 1 2017. Additionally, CBAs in multi-state metropolitan statistical areas have been re-defined so that there are no longer any multi-state CBAs. As a result, the number of CBAs is expanding from nine CBAs in the Round 1 Recompete to 13 CBAs in the Round 1 2017. A list of the ZIP codes included in each CBA is also available on the Competitive Bidding Implementation Contractor (CBIC) website.
The Centers for Medicare & Medicaid Services (CMS) announces bidding timeline, begins bidder education program
Registration for user IDs and passwords opens
Authorized Officials are strongly encouraged to register no later than this date
Backup Authorized Officials are strongly encouraged to register no later than this date
CMS opens bid window for Round 1 2017
Covered Document Review Date for bidders to submit financial documents
Bid window closes
Preliminary bid evaluation notification
CMS announces single payment amounts, begins contracting process
CMS announces contract suppliers, begins contract supplier education campaign and begins beneficiary, referral agent, and supplier education program
January 1, 2017*
Implementation of Round 1 2017 contracts and prices
*Dates listed are target dates
Round 1 2017: Recompete Product Categories
- Enteral Nutrients, Equipment and Supplies
- General Home Equipment and Related Supplies and Accessories
- Includes hospital beds and related accessories, group 1 and 2 support surfaces, commode chairs, patient lifts, and seat lifts
- Nebulizers and Related Supplies
- Negative Pressure Wound Therapy (NPWT) Pumps and Related Supplies and Accessories
- Respiratory Equipment and Related Supplies and Accessories
- Includes oxygen, oxygen equipment, and supplies; continuous positive airway pressure (CPAP) devices and respiratory assist devices (RADs) and related supplies and accessories
- Standard Mobility Equipment and Related Accessories
- Includes walkers, standard power and manual wheelchairs, scooters, and related accessories
- Transcutaneous Electrical Nerve Stimulation (TENS) Devices and Supplies
A list of the specific items in each product category is available on the CBIC website.
Review and Update Enrollment
Suppliers must maintain accurate information on their CMS-855S enrollment application with the National Supplier Clearinghouse (NSC) and in the Provider Enrollment, Chain, and Ownership System (PECOS), including:
- Contact information (name, Social Security number, and date of birth) for authorized official(s) and correspondence address;
- Products and services furnished by the enrolled location(s);
- Each state in which the enrolled location(s) provides items and services; and
- Complete listing of authorized officials. If a supplier has only one authorized official listed on its enrollment record, the supplier should consider adding one or more eligible authorized officials to help with registration and bidding.
It is important to note that if a supplier’s enrollment record is not current at the time of registration, the supplier may experience delays and/or be unable to register and bid. CMS will also validate the bid data with the enrollment record in PECOS during bid evaluation. If it is not accurate, the bid may be disqualified.