February 4, 2010
Medicare’s DMEPOS Competitive Bidding Program
Medicare’s Competitive Bidding Program for durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) is designed to ensure beneficiaries with Original Medicare continue to receive quality medical equipment and related services from accredited suppliers, while reducing out-of-pocket expenses for Medicare beneficiaries and saving the Medicare program money.
Medicare’s current fee schedule rates for DMEPOS items are overpriced and based on outdated, inflated supplier charges from over 20 years ago. Competitive bidding among suppliers will establish new, lower Medicare payment amounts for DMEPOS items.
The DMEPOS Competitive Bidding Program:
· starts January 1, 2011 in nine areas of the country and will be phased into other areas in future years;
· applies to Medicare beneficiaries who live in (or travel to) these areas and who buy or rent certain items of durable medical equipment and supplies;
· includes items such as oxygen equipment and supplies, certain power wheelchairs, walkers, mail order diabetic supplies and hospital beds; and
· selects enough qualified, accredited contract suppliers to meet Medicare beneficiaries’ needs for competitively bid items and services.
The nine initial competitive bidding areas are:
· Charlotte-Gastonia-Concord (North Carolina and South Carolina)
· Cincinnati-Middletown (Ohio, Kentucky and Indiana)
· Cleveland-Elyria-Mentor (Ohio)
· Dallas-Fort Worth-Arlington (Texas)
· Kansas City (Missouri and Kansas)
· Miami-Fort Lauderdale-Pompano Beach (Florida)
· Orlando (Florida)
· Pittsburgh (Pennsylvania)
· Riverside-San Bernardino-Ontario (California)
In order to help you stay fully and accurately informed about Medicare’s DMEPOS Competitive Bidding Program, CMS has prepared the first in a series of “program preview” documents, which can be found at http://www.cms.hhs.gov/Partnerships/03_DMEPOS_Toolkit.asp#TopOfPage. We encourage you to share this information with your local affiliates throughout the country, particularly in the nine initial competitive bidding areas. Please note that “program preview” documents are not intended for distribution to Medicare beneficiaries. We’ll be forwarding materials for you to share with beneficiaries later this year when DMEPOS users may need to take action.