On April 18, 2009, the Centers for Medicare & Medicaid Services (CMS) Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) competitive bidding program became effective. The implementation of the competitive bidding program represents a sea change in the way DME will be furnished to Medicare beneficiaries and should be of acute interest to DME suppliers servicing beneficiaries located in ten selected cities and their surrounding areas, including Cincinnati, Cleveland and Pittsburgh.

Under the DMEPOS competitive bidding program in these selected areas, the currently existing "fee for service" pricing model will be scrapped and suppliers will be required to submit bids to furnish competitively priced items in ten product categories for which payment is made under Medicare Part B. Although the DMEPOS competitive bidding program became effective on April 18, the implementation of the program will have no immediate effect on DMEPOS suppliers, and Medicare beneficiaries may continue to use their current DMEPOS suppliers to receive durable medical equipment.

In the coming weeks, however, CMS will be issuing further guidance to DMEPOS suppliers on the timeline for and bidding requirements related to bids to provide DMEPOS services in the selected competitive bidding areas. In finalizing these guidelines, CMS has indicated that it will continue to solicit input from DMEPOS suppliers impacted by the implementation of the program. If they have not done so already, interested parties should therefore become familiar with the dramatic changes to be implemented as a result of the DMEPOS competitive bidding program, analyze the program's impact on its business and consider providing comments or input to CMS.

More information regarding the DMEPOS competitive bidding program, including supplier eligibility and accreditation standards, can be found in a presentation recently provided by Mark McAndrew on April 17, 2009 to the Ohio Pharmacists Association at its Annual Conference, available at the link below.

Powerpoint: A Primer on CMS’ DMEPOS Competitive Bidding Program