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LATEST NEWS: Medicare Announces Updates to the Competitive Bidding Program for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies The Centers for Medicare & Medicaid Services (CMS) has announced the appointment of new members to serve on the Program Advisory and Oversight Committee (PAOC) for the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) competitive bidding program. These new members will advise CMS as it proceeds with the restart of the competitive bidding program. The list of PAOC members is available at http://www.cms.hhs.gov/DMEPOSCompetitiveBid/downloads/paoc_member_list.pdf. CMS has also announced an interim final rule with comment period (IFC) implementing certain limited changes, required by the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), to the DMEPOS competitive bidding program. The rule may be viewed at http://edocket.access.gpo.gov/2009/pdf/E9-863.pdf. This IFC addresses the MIPPA provisions that affect Round 1 of the DMEPOS competitive bidding program. In particular, it announces the delay of Round 1 of the program from 2007 to 2009. The 2009 Round 1 competition, also known as the Round 1 rebid, will occur in the same metropolitan statistical areas (MSAs) as the 2007 Round 1 bidding, excluding Puerto Rico. The product categories for 2009 will be the same as those selected for the 2007 Round 1 bidding, with the exception of negative pressure wound therapy (NPWT) and Group 3 complex rehabilitative wheelchairs. To view the CBAs/Product Categories, click on the "Product Categories, Items, and HCPCS" link in the left menu. Group 3 complex rehabilitative wheelchairs are also excluded from all subsequent rounds of competition. The IFC also announces the delay of Round 2 of the program from 2009 to 2011, the national mail order program until after 2010 and competition in additional areas, other than mail order, until after 2011. In addition to the delay of the competitive bidding program, the IFC implements the MIPPA process for providing feedback to suppliers regarding missing financial documentation. Suppliers that submit financial documents within a specified time period known as the covered document review date will be notified by CMS regarding any missing financial documentation. If a bidder is notified, it has ten business days to submit the proper information to CMS. This notice only applies to the receipt of the financial documents. It does not include a review of the accuracy of the documents submitted or whether the documents meet applicable requirements. The requirements for bid application will be detailed in the request for bids (RFB). The IFC also implements the MIPPA provision requiring DMEPOS suppliers that are awarded a contract under the program to disclose information to CMS on each subcontracting relationship. While contract suppliers may use subcontractors for certain limited services, the contract suppliers retain responsibility for ensuring that all services under their contracts are appropriately furnished. Contract suppliers must also provide information on whether each subcontractor meets the applicable accreditation requirements. The statute requires that this information be provided to CMS within a specified timeframe. Lastly, the IFC implements the MIPPA exemption for hospitals that provide certain types of durable medical equipment (DME). Specifically, hospitals are exempted from the competitive bidding program when they provide certain types of DME items, like crutches, walkers, and canes, to their own patients during an admission or on the date of discharge. Suppliers wishing to participate in the Round 1 rebid, including those CMS contract suppliers that were awarded contracts in the delayed Round 1, will need to submit a new bid application in the Round 1 rebid. As in the 2007 Round 1 program, suppliers will be required to meet all applicable eligibility, financial, quality and accreditation standards. The MIPPA changes that are addressed in this IFC do not alter the fundamental requirements of the final regulation for the competitive bidding program published on April 10, 2007. There are other MIPPA provisions that affect later rounds of the competitive bidding program that will be addressed in future rulemaking or program guidance. Next Steps: CMS is required to start the Round 1 rebid competition in 2009. In the coming months, announcements and updates containing important information about the DMEPOS Competitive Bidding Program will be provided on this web site and on the CBIC website. Stay up-to-date with the latest information from CMS. Click on the Announcements and Communications page to the left. --------------------------------------------- PROGRAM OVERVIEW Section 302 of the Medicare Modernization Act of 2003 (MMA) established requirements for a new competitive bidding program for certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS). The MMA requires that competitive bid payment amounts be used to replace the current Medicare DMEPOS fee schedule payment amounts for selected items in selected areas. The competitive bid payment amounts are determined by using bids submitted by DMEPOS suppliers. The intent of the competitive bidding program is to set more appropriate payment amounts for DMEPOS items, which will result in reduced beneficiary out-of-pocket expenses and savings to taxpayers and the Medicare program. Note that all suppliers must be accredited by October 01, 2009. For more information on accreditation, please visit the CMS Medicare Provider-Supplier Enrollment Accreditation page, which can be found under the "Related Links Inside CMS" section below.
Page Last Modified: 01/16/2009 1:42:42 PM
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