Medicare Part B: Competitive Bidding
New DME and Enteral Supplies Round 2 payment rules under Medicare Part B Competitive Bidding are to take effect July 1, 2013.
In preparation for the new Medicare Part B Competitive Bidding rules slated to take effect on July 1, 2103, LeadingAge NY hosted an audio conference in May entitled: DME Competitive Bidding: What Does This Mean to My Residents and Staff?, with an encore presentation available by clicking on this link.
Under the new rules, selected durable medical equipment, prosthetics orthotics and supplies (DMEPOS) will be subject to sole-source coverage by only those suppliers granted awards by CMS. The new Round 2 covers:
- Oxygen, oxygen equipment, and supplies
- Standard (Power and Manual) wheelchairs, scooters, and related accessories
- Enteral nutrients, equipment, and supplies
- Continuous Positive Airway Pressure (CPAP) devices and Respiratory Assist Devices (RADs) and related supplies and accessories
- Hospital beds and related accessories
- Walkers and related accessories
- Negative Pressure Wound Therapy pumps and related supplies and accessories
- Support surfaces (Group 2 mattresses and overlays)
A CMS interactive map feature indicating those areas of New York covered under Round 2 is available by clicking here.
A CMS “Find the Supplier” feature by zip code is available by clicking here.
Providers who need to coordinate care between Part A and Part B will need to ensure that the proper suppliers are used according to the contracts issued by CMS earlier this year. For many providers, this has meant adjusting their previous contracts with suppliers. At this point, there is no word on any delays to the July 1 implementation date.
Your contracted DMEPOS supplier is your best source of guidance on how contracting arrangements may need to be adjusted. CMS has awarded prime contracts to those bidders who were successful in the competitive bidding process. The prime contractor can then subcontract with an accredited supplier. To ensure that Medicare Part B coverage is properly coordinated, it is important that you check with your current Part B supplier to ensure continuity of coverage as of July 1.
For more details, CMS has a comprehensive listing of DMEPOS Competitive Bidding Medlearn Articles and Fact Sheets available by clicking here.
There is also a CMS YouTube video available by clicking here.
Please keep in mind that this effects Medicare Part B, and providers are still free to use any approved DMEPOS supplier for which the provider pays for the supplies used in a Medicare Part A stay. As noted, there would need to be close coordination between the Part A and Part B suppliers in such arrangements.
Contact: Patrick Cucinelli, pcucinelli@leadingageny.org, 518-867-8827