Medicare Announces the Contract Suppliers for the First Round of the Medicare DMEPOS Competitive Bidding Program The Centers for Medicare & Medicaid Services (CMS) has announced the contract suppliers for the first round of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. The competitive bidding program will offer beneficiaries in the designated competitive bidding areas (CBAs) access to quality DMEPOS products and services with lower out-of-pocket costs. A total of 325 suppliers receiving 1,345 contracts were selected for the ten Round 1 communities. To participate in the program, suppliers were required to meet Medicare's financial and quality standards. In addition, suppliers had to be accredited by one of CMS' approved accrediting organizations to be eligible to receive a contract. To take advantage of the savings available under the program, people with Medicare living in one of the CBAs will need to choose a new supplier if their current supplier is not a contract supplier or a supplier who may be allowed to offer items and supplies as a grandfathered supplier. Grandfathered suppliers are those who chose to continue to provide certain rented durable medical equipment, oxygen and oxygen equipment for existing clients. As a Medicare provider, CMS has many educational and informational resources available to assist you in your role as a DMEPOS supplier or referral agent. All of these resources, including the single payment amounts, links to both provider and beneficiary educational materials, and the most current news and announcements regarding the program, can be accessed through our DMEPOS Competitive Bidding Web Page . The List of Contract Suppliers - Round 1 is now available on the Competitive Bidding Implementation Contractor (CBIC) website.
---------------------------------- Payment for Complex Rehabilitative Power Mobility Device Services that Span the Implementation Date of DMEPOS Competitive Bidding Programs in Competitive Bidding Areas CMS will be issuing instructions in the near future about a one-time DMEPOS competitive bidding transition policy for suppliers of purchased Group 3 single or multiple power option power mobility devices (PMDs) furnished to beneficiaries in competitive bidding areas (CBAs). In specific cases described below, suppliers who, prior to July 1, 2008, begin furnishing services related to providing these devices, but do not deliver the final PMD product until July 1, 2008, or later will be paid based on the 2008 fee schedule amounts for furnishing these PMDs to beneficiaries residing in Round One CBAs. This transition policy applies to both contract and noncontract suppliers. The HCPCS codes subject to the transition policy include PMD codes K0856 thru K0864 and related accessories provided at the time the PMD is delivered to a beneficiary who resides in a Round One CBA. The specific claims subject to the transition policy are items that are delivered for use in the beneficiary's home on or after July 1, 2008, for which the supplier has:
A signed order from the physician that is dated between April 1, 2008 and May 31, 2008; and
Documentation that the face-to-face beneficiary examination by the physician that is necessary to determine medical necessity for the PMD occurred before July 1, 2008. This documentation should be maintained by the supplier, but does not need to be submitted at the time the claim for the PMD is submitted. However, it should be made available upon request.
Suppliers should use the date of the physician order as the date of service on the claim (other than this limited, one-time exception, suppliers should be aware that the date of service that is recorded on a DMEPOS claim is the date that the item is delivered). In addition, suppliers should include on the claim for the PMD all accessories provided with the PMD and should use the same date of service used for the PMD for these items. Suppliers should report the date the PMD and related accessories were delivered for use in the beneficiary's home in the narrative section of the claim.
------- Revised ACCREDITATION Deadlines FOR DMEPOS Competitive Bidding! In order to participate in the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program, suppliers must meet quality standards and be accredited by a CMS-approved Deemed Accreditation Organization. Suppliers that are interested in bidding in the second round of the program must be aware of changes to two key deadlines:
Suppliers must be accredited or have applied for accreditation by July 21, 2008 (change from May 14, 2008) to submit a bid for the second round of competitive bidding. CMS cannot accept a bid from any supplier that is not accredited or that has not applied for accreditation by July 21, 2008.
Suppliers will need to be accredited to be awarded a contract. The accreditation deadline for the second round of competitive bidding is January 14, 2009 (change from October 31, 2008). Suppliers must be accredited before this date to be awarded a contract. Suppliers should apply for accreditation immediately to allow adequate time to process their applications.
CMS has extended these deadlines because a significant number of suppliers in the 70 metropolitan statistical areas (MSAs) included in Round Two of the DMEPOS Competitive Bidding Program have not yet applied for accreditation. Suppliers in these MSAs that do not meet these accreditation deadlines cannot become DMEPOS competitive bidding contract suppliers and will therefore be unable to furnish competitively bid items to any beneficiary residing in any part of the competitive bidding area during the contract period. Suppliers can determine if they are serving beneficiaries in a Round 2 MSA by visiting the following web site: Current Lists of Metropolitan and Micropolitan Statistical Areas and Definitions and looking up their MSAs in the section called "counties with metropolitan and micropolitan statistical area codes." (In this file, MSAs are called CBSAs.) For example, the Los Angeles-Long Beach-Santa Ana, CA MSA is comprised of two counties: Los Angeles and Orange. We urge all suppliers serving Medicare beneficiaries in the 70 Round Two MSAs to apply for accreditation now.
For a list of the CMS-approved Deemed Accreditation Organizations, visit the DMEPOS Accreditation web page. Visit the Medicare DMEPOS Competitive Bidding Program web page for more information. ----------- Reminder: CMS to Host Second National Provider Education Call on May 27th, 2008 The Centers for Medicare & Medicaid Services (CMS) will host the second national provider education conference call to address the implementation of the new Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding program scheduled to begin on July 1, 2008. This call is being conducted for Medicare fee-for-service DMEPOS suppliers, physicians, and other providers " all of which may be affected by the program. CMS Subject Matter Experts will be available to answer questions and address some of the exceptions and situations you may encounter as the program is implemented. To view a PowerPoint presentation that was used in the first national call, please click here: http://www.cms.hhs.gov/DMEPOSCompetitiveBid/Downloads/policy_teleconference_final.pdf Conference call details: Date: May 27, 2008
Conference Title: Medicare DMEPOS Competitive Bidding Program Q&A session
Time: 1:00-2:30 EDT In order to receive the call-in information, you must register for the call. It is important to note that if you are planning to sit in with a group, only one person needs to register to receive the call-in data. This registration is solely to reserve a phone line, NOT to allow participation. If you cannot attend the call, replay information is available below. Registration will close at 1:00 p.m. EDT on May 26, 2008, or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time. 1. To register for the call participants need to go to: http://www2.eventsvc.com/palmettogba/052908 2. Fill in all required data. 3. Verify your time zone is displayed correctly the drop down box. 4. Click "Register". 5. You will be taken to the "Thank you for registering" page and will receive a confirmation email shortly thereafter. Note: Please print and save this page, in the event that your server blocks the confirmation emails. If you do not receive the confirmation email, please check your spam/junk mail filter as it may have been directed there. For those of you who will be unable to attend, a replay option will be available shortly following the end of the call. This replay will be accessible from 4:00 p.m. EDT 5/27/2008 until 11:59 p.m. EDT 6/4/2008. The call in data for the replay is (800) 642-1687 and the passcode is 47261135. | Downloads |
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