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MEDICARE EXPANDING COMPETITIVE BIDDING PROGRAM TO SAVE BILLIONS

MEDICARE EXPANDING COMPETITIVE BIDDING PROGRAM TO SAVE BILLIONS
PROGRAM EXPANDED BY AFFORDABLE CARE ACT

The Centers for Medicare & Medicaid Services (CMS) today announced operational details for the next stage in a program that sets new, lower payment rates for certain medical equipment and supplies – such as oxygen equipment, walkers, and some types of power wheelchairs – while maintaining patient access to them. CMS today also launched a comprehensive education program to help guide suppliers through the competitive bidding process.

 

The Medicare Competitive Bidding Program for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) was expanded by the Affordable Care Act and is estimated to save Medicare, seniors, and taxpayers more than $28 billion over 10 years.  Already in 2011, the first phase of the program has saved Medicare 35 percent compared to the fee schedule and resulted in lower cost for Medicare patients.

 

“Today marks another step forward in our progress towards obtaining fair prices for equipment like wheelchairs and walkers,” said CMS Administrator Donald M. Berwick, M.D. “We are looking forward to a robust competition that will achieve better value and preserve access for our beneficiaries.”

 

Under the program, DMEPOS suppliers compete to become Medicare contract suppliers by submitting bids to provide certain items in competitive bidding areas (CBAs).  The new, lower payment amounts resulting from the competition replace the fee schedule amounts for the bid items in these areas.  

 

The first phase of the program was successfully implemented for nine product categories in nine areas of the country on Jan. 1, 2011.   To date, CMS monitoring data have shown a successful implementation with no changes in beneficiary health status.  Today, CMS released the detailed schedule for Round 2 bidding.  Registration will begin on December 5, and the 60-day supplier bidding period will begin in late January of 2012. 

 

Round 2 expands the program to 91 additional metropolitan areas, and the new prices are expected to take effect on July 1, 2013. A National Mail Order Competition to help bring down prices for mail order diabetic supplies will coincide with the Round 2 timeline.  

 

The bidder education program launched today is designed to guide suppliers through the competitive bidding process and will feature numerous enhancements such as improved Request for Bids instructions, updated fact sheets, and a series of webcasts that suppliers will be able to view at their convenience.  Information and materials may be found at www.dmecompetitivebid.comand a toll-free help line (1-877-577-5331) is available to assist bidders with questions and concerns. 

 

“We have considered feedback from many stakeholders to implement process improvements to make the competitive bidding program even stronger,” said Jonathan Blum, deputy CMS administrator and director of the Center for Medicare. “In addition to the enhancements we’ve made to our bidder education program, we will be strengthening our rigorous bid evaluation process by increasing our scrutiny of bids.”

 

The Round 2 categories of products are similar to those in Round 1, with some additions.  The Round 2 product categories are:

 

·        Oxygen, oxygen equipment, and supplies;

·        Standard (Power and Manual) wheelchairs, scooters, and related accessories (a new category that combines all mobility devices);

·        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 (new category);

·        Support surfaces (Group 2 mattresses and overlays).

 

Beneficiaries may continue to use their current suppliers at this time. Similar to the successful 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.

           

Additional information on the competitive bidding program is available at: http://www.cms.gov/DMEPOSCompetitiveBid/01_overview.asp#TopOfPage

 

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