Medicare's Competitive Bidding Program and Enteral Nutrition
Round One of this program was put into effect on January 1, 2011, in nine communities across the U.S. (these “competitive bidding areas,” or CBAs, as well as details of the program, are listed below).
Competitive Bidding Program Background
In brief, the program involves durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) covered under Medicare Part B—which includes enteral nutrition. The stated program goal is to lower costs for Medicare and for beneficiaries—you—by using the local, competitive marketplace to lower the costs for DMEPOS for beneficiaries who use the Medicare-contracted suppliers for these items. Because you pay coinsurance on the cost of DMEPOS, you will directly benefit from the savings.
Medicare states that contracts were awarded to suppliers who offered the best price; met Medicare’s eligibility, quality, and financial standards; and are accredited by an independent accrediting organization. (You can find a list of contract suppliers in your area at www.cms.gov/DMEPOSCompetitiveBid/01A2_Contract_Supplier_Lists.asp or by calling 800-MEDICARE.)
CBAs and Product Categories
The areas covered in Round One are: Charlotte/Gastonia/Concord (NC and SC); Cincinnati/Middletown (OH, KY, and IN); Cleveland/Elyria/Mentor (OH); Dallas/Fort Worth/Arlington (TX); Kansas City (MI and KS); Miami/Fort Lauderdale/Pompano Beach (FL); Orlando/Kissimmee (FL); Pittsburgh (PA); and Riverside/San Bernardino/Ontario (CA).
The items covered include: enteral nutrients, equipment, and supplies; oxygen, equipment, and supplies; standard power wheelchairs, scooters, and related accessories; complex rehabilitative power wheelchairs and related accessories (Group 2 only); mail-order diabetic supplies; continuous positive airway pressure (CPAP) devices; respiratory assist devices (RADs), and supplies and accessories; hospital beds and accessories; walkers and accessories; support surfaces (Group 2 mattresses and overlays in Miami/Ft. Lauderdale/Pompano Beach only).
Medicare is Looking for Your Feedback
Has Round One of this Program affected you? Please share your experiences good or bad - with us or directly with Medicare. They have asked for input, and your experiences may influence the future direction of this program .
If your old supplier is not a contract supplier, you have probably had to choose a new supplier. If you are on multiple therapies (for example, tube feeding and oxygen), you may have had to choose one supplier for one therapy and another for a second therapy. So how has this affected you? Are you getting your supplies in a timely manner? Are you able to get what you need? If you have had to choose a new supplier, has the transition gone smoothly?
Contact Joan Bishop at bishopj@mail.amc.edu or (800) 776-6539; or Medicare at www.cms.hhs.gov/DMEPOSCompetitiveBid or (888) 990-0499.
Round Two
In April, Medicare announced that it is delaying Round Two of the Competitive Bidding Program by at least six months. In Round Two, the program will be implemented in ninety-one additional areas nationwide.
Following the newly proposed schedule, the Round Two product categories will be announced this summer. Then bidder registration, bidding, and bidding evaluation would occur. The contract suppliers would be announced in the spring of 2013 and Round Two would be implemented in the summer of 2013.
Proposed Legislation Makes Your Input Vital
A bill has been introduced in the House to repeal the competitive bidding program (H.R. 1041, the Fairness in Medicare Bidding Act), which makes your feedback all the more critical. Now is the time to let Oley, Medicare or your congressional representatives know how the Competitive Bidding Program works in the day-to-day lives of those it affects.
Updated 4/29/11