CMS Announces Next Phases of DME Bidding Program

The Centers for Medicare & Medicaid Services (CMS) has announced the next steps of its Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program, including the bidding timeline for the Round 2 re-compete and the national mail-order re-compete.

As required by law, CMS made its announcements last Thursday, also launching a comprehensive bidder education program in the process. The program is designed to ensure that DMEPOS suppliers interested in bidding receive the information and assistance they need to submit complete bids in a timely manner, CMS stated in a release detailing its 

“Today marks another step forward in ensuring access to quality health care for millions of Medicare beneficiaries,” said CMS Administrator Marilyn Tavenner in a written statement. “The DMEPOS competitive bidding program has proven to be effective in obtaining fair prices for quality equipment like wheelchairs and walkers.”

The competitive bidding program saved more than $580 million in the nine markets at the end of the Round 1 re-bid’s three-year contract period, which CMS attributes to lower payments and “decreased unnecessary utilization.”

CMS is required by section 1847(b)(3) of the Social Security Act to re-compete contracts under the DMEPOS Competitive Bidding Program at least once every three years. 

Suppliers must then become a Medicare contract supplier by submitting bids to provide certain items in competitive bidding areas.

CMS also attributed additional savings of $2 billion to the Medicare program as a result of the expansion of the bidding program, specifically at the end of the first year of Round 2 and the national mail-order programs. 

Competitive bidding has been a wellspring of controversy since its was mandated by Congress through the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. 

Home health agency operators, industry trade groups and other stakeholders have decried the effectiveness of the bid program, stressing that certain provisions within the program’s structure invites providers to “game the system” by submitting non-binding bids, above all else substantially limiting the abilities of elders and people living with disabilities to receive DMEPOS equipment across the country.

The issue has also garnered the attention of Congress this year, with proposed legislation from both the House and Senate to correct what some believe to be critical flaws within the program.

For those seeking information, the Competitive Bidding Implementation Contractor (CBIC) website features an array of resources for suppliers, including the bidding timeline, bidding rules, short instructional videos, user guides, fact sheets and more. 

Written by Jason Oliva

Jason Oliva