Delay of the National DMEPOS Competitive Bidding Program: Claims Processing
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Delay of the National DMEPOS Competitive Bidding Program: Claims Processing

Section 154 of the Medicare Improvements for Patients and Providers Act of 2008 delays the DMEPOS Competitive Bidding Program.  Therefore, in the 10 areas where competitive bidding was initiated, Medicare will pay for DMEPOS items, retroactive to June 30, 2008, using the standard DMEPOS fee schedule amounts.

CMS will begin processing all incoming claims under standard FFS rules, no later than July 28, 2008.  Any claims that were held will be processed no later than August 4, 2008.

To the extent possible, CMS will also automatically reprocess claims that were paid under the Competitive Bidding Program and those claims denied based solely due to DMEPOS Competitive Bidding Program rules.

Note that in some instances suppliers will need to alert the contractor to claims that should be adjusted.

CMS will soon issue contractor instructions and issue accompanying MLN Matters articles with more information.

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