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DMEPOS Competitive Bidding Basics: The 5 W’s

by admin on April 10, 2019 1 comment

competitive biddingBy: Michael Silverman

WHO (does it impact)?

Any Medicare enrolled DMEPOS supplier that desires to service a Medicare Part B beneficiary with any medical equipment or device that is included in Medicare’s Competitive Bidding Program.

WHAT (is competitive bidding and what DMEPOS supplies are covered)?

In a nutshell, it’s essentially this: if a DMEPOS supplier wants to service a Medicare Part B patient with any of the following medical supplies covered by Medicare’s Competitive Bidding Program, such supplier must submit and win a ‘bid’ to provide such item in each and every geographic region covered by the Competitive Bidding Program in which they wish to be able to service beneficiaries within.

 Commode Chairs Continuous Positive Airway Pressure (CPAP) Devices and Respiratory Assist Devices (RADs) Enteral Nutrition  Hospital Beds

 

 Nebulizers Negative Pressure Wound (NPWT) Pumps Non-Invasive Ventilators  Off-The-Shelf (OTS) Back Braces
Off-The-Shelf (OTS) Back Braces Oxygen and Oxygen Equipment Patient Lifts and Seat Lifts Standard Manual Wheelchairs
Standard Power Mobility Devices Support Surfaces Transcutaneous Electrical Nerve Stimulation (TENS) Devices Walkers

 

WHERE (are the geographic regions covered by the Competitive Bidding Program)?

There are 130 Competitive Bidding Areas covered by the Competitive Bidding Program. (Find list of the CBA’s HERE)

WHEN (does ‘bidding’ take place and become effective)?

May 2019 – CMS will announce the dates for registration and bidding, and will also begin its bidder education program;

June 2019 – Bidder registration begins, and the bid window opens.

January 2021 – This latest round of Competitive Bidding becomes effective. Again, as of Jan. 1, 2021, if a medical item or device was subjected to Competitive Bidding, only those suppliers that won a ‘bid’ for that specific category of supplies and in that particular geographic area the patient resides in can service that Medicare Part B beneficiary.

WHY (was Competitive Bidding created and why should providers care)?

Fraud, waste and abuse concerns, as well as to increase efficiency and to bring down the overall costs of DMEPOS to the beneficiary, taxpayers, and government. If a provider does not participate, it will not be able to seek reimbursement for any medical supplies subject to the Competitive Bidding Program that are supplied to Medicare Part B beneficiaries.

And as a bonus ‘sneak peek’ of more to come . . . . .

HOW (does a supplier prepare to submit a bid)?

  1. The DMEPOS provider must be enrolled as a Medicare Part B supplier with a PTAN in order to even be able to submit a bid.
  2. Prepare required financial documentation – Tax Return; Financial Statements; Credit Reports (Click HERE for additional information)
  3. Bid Bonds – a supplier cannot submit a bid for consideration unless and until it has obtained a bid surety bond from an authorized company in the amount of $50,000.00 per region for each region it wants to provide competitively bid items into. Remember, there are 130 Competitive Bidding Areas covered by the Competitive Bidding Program – that’s a lot of required bond money for a supplier looking to participate nationwide. Click HERE for additional information)
  4. The actual bidding process is done through CMS’ Connexion portal. Providers must submit a bona fide bid amount for the lead item of each category of supplies, in each region, to which it wishes to provide DMEPOS subject to the Competitive Bidding Program into.
adminDMEPOS Competitive Bidding Basics: The 5 W’s

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