On August 19, 2011, CMS issued a press release and a fact sheet describing the next steps that will be taken to expand the durable medical equipment prosthetics, orthotics, and supplies (DMEPOS) competitive bidding program. The competitive bidding program, established by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), replaces the DMEPOS fee schedule for certain DMEPOS products in certain competitive bidding areas (CBAs) with competitive bid pricing. The MMA required that the DMEPOS competitive bidding program be implemented in phases. Round one, which consisted of ten DMEPOS products and ten CBAs, was implemented by CMS on July 1, 2008. However, the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) temporarily delayed round one and required the termination of all round one DMEPOS supplier contracts. The round one rebid, which consisted of nearly the same DMEPOS products and CBAs as round one, was fully implemented on January 1, 2011. According to CMS, the competitively bid pricing obtained through the round one rebid process has resulted in savings of 35% compared to the DEMPOS fee schedule.
In the press release and fact sheet, CMS provided details regarding round two of the DMEPOS competitive bidding program, which will involve an expansion of the program to 91 additional metropolitan areas (MSAs) and additional DMEPOS product categories. A list of the 91 additional MSAs is available by clicking here. CMS announced that the DMEPOS product categories that will be subject to round two are:
- Oxygen, oxygen equipment, and supplies
- Standard (Power and Manual) wheelchairs, scooters, and related accessories
- Enteral nutrients, equipment, and supplies
- Continuous Positive Airway Pressure (CPAP) devices and Respiratory Assist Devices (RADs) and related supplies and accessories
- Hospital beds and accessories
- Walkers and related accessories
- Negative Pressure Wound Therapy pumps and related supplies and accessories
- Support surfaces (Ground 2 mattresses and overlays)
The specific items within each of the above DEMPOS product categories is available by clicking here.
CMS provided the following timeline for the completion of round two:
- Summer 2011. CMS will begin pre-bidding supplier awareness program
- Fall 2011. CMS will announce the bidding schedule, begin a bidder education program, and begin bidder registration to obtain user identifications and passwords
- Winter 2012. Bidding will begin
- July 1, 2013. Implementation of round two pricing
Contemporaneous with round two, CMS will also conduct a national mail order competition for diabetic testing supplies. CMS’s press release is available by clicking here. CMS’s fact sheet is available by clicking here.