LEEDer Group Inc.
8508 North West 66th St.
Miami, Florida 33166 USA

Phone: 305.436.5030
Fax: 305.436.0086
E-mail Address: info {at] LEEDerGroup [dot] com

2011-01 Three Important DMEPOS Competitive Bidding Updates

December 22, 2010

Three Important DMEPOS Competitive Bidding Updates

Three updates that will be of interest to the provider community regarding the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program:

DMEPOS Competitive Bidding Program Information Mailed to Referral Agents

The DMEPOS Competitive Bidding Program will go into effect for nine product categories in nine competitive bidding areas (CBAs) on Sat Jan 1, 2011. When the program becomes effective, beneficiaries with Original Medicare who obtain competitively bid items in CBAs must obtain these items from a contract supplier for Medicare to pay, unless an exception applies.

  • The nine product categories are:
    1. Oxygen, oxygen equipment, and supplies;
    2. Standard power wheelchairs, scooters and related accessories;
    3. Complex rehabilitative power wheelchairs and related accessories (Group 2 only);
    4. Mail-order diabetic supplies;
    5. Enteral nutrients, equipment, and supplies;
    6. Continuous Positive Airway Pressure (CPAP) devices and Respiratory Assist Devices (RADs) and related supplies and accessories;
    7. Hospital beds and related accessories;
    8. Walkers and related accessories; and
    9. Support surfaces (Group 2 mattresses and overlays in Miami-Fort Lauderdale-Pompano Beach, FL only).

  • The nine competitive bidding areas are:
    1. Charlotte-Gastonia-Concord, NC-SC;
    2. Cincinnati-Middletown, OH-KY-IN;
    3. Cleveland-Elyria-Mentor, OH;
    4. Dallas-Fort Worth-Arlington,
    5. TX; Kansas City, MO-KS;
    6. Miami-Fort Lauderdale-Pompano Beach, FL;
    7. Orlando-Kissimmee, FL;
    8. Pittsburgh, PA;
    9. Riverside-San Bernardino-Ontario, CA.

It is crucial that health care professionals who order items included in the program understand how this program will affect their Medicare patients so that Medicare will continue to pay for covered services. Therefore, the Centers for Medicare & Medicaid Services (CMS) is in the process of mailing a letter to referral agents in CBAs to remind them that the program is starting on Sat Jan 1, 2011. For purposes of the Medicare DMEPOS Competitive Bidding Program, “referral agentâ€? includes such entities as Medicare enrolled providers, physicians, treating practitioners, discharge planners, social workers, and pharmacists who refer beneficiaries for services in a CBA. “(external)A copy of the letter is now available on the CMS website at http://www.cms.gov/DMEPOSCompetitiveBid/04_Educational_Resources.asp.

Supplier Locator Tool Updated for DMEPOS Competitive Bidding

CMS has updated its online supplier locator tool with new features for the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. Here’s how to access a list of DMEPOS competitive bidding contract suppliers for a particular beneficiary’s competitive bidding area using the updated online supplier locator tool:
Visit www.Medicare.gov/supplier.
Enter the Medicare beneficiary’s zip code and click “Submit.�
A list of product categories will appear; those product categories with a star icon next to them are included in the Competitive Bidding Program.
After selecting a competitive bidding product category, click “View Results.�
A page will display stating you’ve selected a competitive bidding product category and briefly explain the program; click “Continue.â€? A list of all Medicare contract supplier locations in the competitive bidding area will appear. A list of the CMS-designated Medicare DMEPOS Competitive Bidding Program contract suppliers for each CBA can also be found…CLICK HERE.

DMEPOS Competitive Bidding Program “Repairs and Replacements Fact Sheet� Now Available from the Medicare Learning Network

The DMEPOS Competitive Bidding Program “Repairs and Replacements Fact Sheet� is now available to download, free of charge, from the Medicare Learning Network®.
Once the DMEPOS competitive bidding program becomes effective on Sat Jan 1, 2011, beneficiaries with Original Medicare who obtain competitively bid items in competitive bidding areas (CBAs) must obtain these items from a contract supplier for Medicare to pay, unless an exception applies. One exception occurs when an item of DMEPOS that a beneficiary already owns needs to be repaired. This fact sheet contains helpful information on competitive bidding program rules that apply when an item of DMEPOS that is owned by a beneficiary needs to be repaired or requires replacement parts. It includes information on which items and services non-contract suppliers may provide, and which Healthcare Common Procedure Coding System (HCPCS) codes can be considered replacement parts associated with repair of base equipment. To view the fact sheet, please visit the DMEPOS Competitive Bidding Educational Resources page…CLICK HERE
Scroll down to “Downloads,� and select “DMEPOS Competitive Bidding Fact Sheets.�

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