The Centers for Medicare & Medicaid Services (CMS) have announced the Metropolitan Statistical Areas (MSAs) and product categories for the second round of the Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) new competitive bidding program.  The program is designed to improve the effectiveness of Medicare's DMEPOS payments, reduce beneficiary out-of-pocket costs, and save the Medicare program money while ensuring beneficiary access to quality DMEPOS items and services by requiring suppliers to be accredited by a Medicare-recognized accreditation organization.

All suppliers must meet quality standards and be accredited by a CMS-recognized accreditation organization in order to obtain a contract under the Medicare DMEPOS competitive bidding program.  Due to the size of this expansion and CMS' experiences from round 1 of the program,they strongly encourage suppliers to seek accreditation as soon as possible to avoid any potential difficulties that would affect their ability to bid.  Information on accreditation requirements and a list of CMS-recognized accreditation organizations can be found on this web page.

Metropolitan Statistical Areas for Second Round of Competitive Bidding

The second round of bidding will occur in the following 70 Metropolitan Statistical Areas (MSAs):

The program will be expanded into additional areas after 2009.

CMS plans to announce the competitive bidding areas (CBAs) specific Zip Codes by MSAs in which competitive bidding will be conducted in the next few months.

A competitive bidding area (CBA) is defined by specific zip codes by MSA.  The CBA may be concurrent with, larger than or smaller than the related MSA depending on a variety of considerations including the exclusion of low population-density areas within the MSA and the inclusion of a part of a normal service area.  The CBA will be the area wherein contract suppliers will furnish certain DMEPOS items to resident beneficiaries.

Affected Product Categories

The second round of the Medicare DMEPOS Competitive Bidding program will include 8 of the top DMEPOS product categories.  These product categories were selected based on criteria outlined in the regulation.  The following are the product categories for round two:

1 – Oxygen Supplies and Equipment

2 – Standard Power Wheelchairs, Scooters, and Related Accessories

3 – Complex Rehabilitative Power Wheelchairs and Related Accessories

4 – Enteral Nutrients, Equipment, and Supplies

5 – Continuous Positive Airway Pressure (CPAP) Devices, Respiratory Assist Devices (RADs), and Related Supplies and Accessories

6 – Hospital Beds and Related Accessories

7 – Negative Pressure Wound Therapy (NPWT) Pumps and Related Supplies and Accessories

8 – Walkers and Related Accessories

A listing of the items contained in each product category will be announced in the next few months.

Next Steps:

Over the next few months, announcements and updates containing important information about the second round of the Medicare DMEPOS Competitive Bidding Program will be provided on the CBIC website.  Some of the more significant upcoming updates will include:

• A detailed timeline
  
• Announcement of Competitive Bidding Areas (CBAs) and items in each product category.
  
• Initial registration for suppliers interested in competitive bidding
  
• Educational opportunities
  
• Other informational resources/fact sheets about the program

COMPETITIVE BIDDING FOR DMEPOS - EDUCATION

The Centers for Medicare & Medicaid Services (CMS) and its implementation contractor (CBIC) have issued important supplier educational materials.  These materials can be found on the CBIC web-site at:
http://www.dmecompetitivebid.com/cbic/cbic.nsf/(pages)/home.  Announcements concerning future supplier education activities can also be found here.

GET ACCREDITED FOR DMEPOS COMPETITIVE BIDDING

In order to participate in the Medicare DMEPOS Competitive Bidding Program, suppliers must meet quality standards and be accredited by a CMS-approved Deemed Accreditation Organization.Suppliers must be accredited or be pending accreditation to submit a bid.  CMS cannot accept a bid from any supplier that is not accredited or that has not applied for accreditation.

For a list of the CMS-approved Deemed Accreditation Organizations and information about the Medicare DMEPOS Competitive Bidding program, see the "Related Links Inside CMS" section.