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

Phone Toll-free: 866.814.0192 or 305.436.5030
Fax Toll-free: 866.818.0373 or 305.436.0086
E-mail Address: orders {at] LEEDerGroup [dot] com

2013-05 ReBid ReCompete Competitive Bidding Program Every 3 Years

KYDEX-PRO

STRONGER

SAFER

LEEDerGroup.com

LEEDerGroup.com NOTE: this is dated but serves as an historical document
MLN MattersĀ®Number: MM8316 Related Change Request (CR) #: CR 8316
Related CR Release Date: May 24, 2013 Effective Date: October 1, 2013
Related CR Transmittal #: R2712CP Implementation Date: October 7, 2013

Quarterly Update for the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program (CBP) – October 2013
  • Provider Types Affected
    This MLN MattersĀ® Article is intended for DMEPOS suppliers submittin
    claims to Durable Medical Equipment Medicare Administrative Contractors (DME MACs) or Medicare Regiognal Home Health Intermediaries (RHHIs) for DMEPOS provided to Medicare beneficiaries.
  • Provider Action Needed
    The Centers for Medicare & Medicaid Services (CMS) issued Change Request (CR) 8316 to provide the DMEPOS CBP October 2013 quarterly update. Change Request (CR) 8316 provides specific instructions for implementing updates to the DMEPOS CBP Healthcare Common Procedure Coding System (HCPCS), ZIP code, and Single Payment Amount files.
  • Background
    Section 302 of the Medicare Modernization Act of 2003 (MMA) established requirements for a new CBP for certain DMEPOS. Under the program, DMEPOS suppliers compete to become Medicare contract suppliers by submitting bids to furnish certain items in competitive bidding areas, and CMS awards contracts to enough suppliers to meet beneficiary demand for the bid items. The new, lower payment amounts resulting from the competition replace the Medicare DMEPOS fee schedule amounts for the bid items in these areas. All contract suppliers must comply with Medicare enrollment rules, be licensed and accredited, and meet financial standards. The program sets more appropriate payment amounts for DMEPOS items while ensuring continued access to quality items and services, which will result in reduced beneficiary out-of-pocket expenses and savings to taxpayers and the Medicare program. Under the MMA, the DMEPOS CBP was to be phased in so that competition under the program would first occur in 10 Metropolitan Statistical Areas (SAs) areas in 2007. The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) temporarily delayed the program in 2008 and made other limited changes. As required by MIPPA, CMS conducted the supplier competition in nine MSAs in 2009, referring to it as the Round 1 Rebid. The Round 1 Rebid contracts and prices became effective on January 1, 2011.
    MIPPA also delayed the competition for Round 2 from 2009 to 2011 and authorized national mail order competitions after 2010. The Affordable Care Act of 2010 (ACA) expanded the number of Round 2 MSAs from 70 to 91. Contracts and prices for Round 2 and the national mail-order program for diabetic testing supplies are scheduled to go into effect on July 1, 2013.
    MIPPA also delayed the competition for Round 2 from 2009 to 2011 and authorized national mailorder competitions after 2010. The Affordable Care Act of 2010 (ACA) expanded the number of Round 2 MSAs from 70 to 91. Contracts and prices for Round 2 and the national mail-order program for diabetic testing supplies are scheduled to go into effect on July 1, 2013.
    CMS is required by law to recompete contracts for the DMEPOS CBP at least once every three years. The Round 1 Rebid contract period for all product categories except mail-order diabetic supplies expires on December 31, 2013. (The Round 1 Rebid mail-order diabetic supply contracts expired on December 31, 2012.) CMS is conducting the Round 1 Recompete in the same competitive bidding areas as the Round 1 Rebid.

More information on Round Two is also available at-CLICK-HERE on the Internet. The information at this site includes information on all rounds of the CBP, including product categories; single payment amounts for the Round 1 Rebid, Round 2, and the national mail-order program for diabetic testing supplies; and the ZIP codes of areas included in the CBP.