CMS NEWS

FOR IMMEDIATE RELEASE
January 31, 2017
Contact: CMS Media Relations
(202) 690-6145 | CMS Media Inquiries

DMEPOS Competitive Bidding Round 2019 Announced

The Centers for Medicare & Medicaid Services (CMS) today announced plans to consolidate all rounds and areas included in the Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program into a single round of competition – Round 2019. After the current Round 1 2017, Round 2 Recompete, and National Mail-Order competitions conclude on December 31, 2018, Round 2019 contracts will become effective on January 1, 2019 through December 31, 2021. Round 2019 will include 141 competitive bidding areas (CBAs) and have a total of 11 product categories.

The DMEPOS Competitive Bidding Program, mandated by Congress through the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), changes the amount Medicare pays for certain equipment like walkers and wheelchairs using market-based prices, while maintaining beneficiary access to items and services and quality of care. The program replaces the outdated, inflated fee-schedule prices Medicare paid for these items with lower, more accurate prices to help Medicare and its beneficiaries save money while ensuring access to quality equipment, supplies, and services. This program also helps limit fraud and abuse in Medicare.

“The Medicare DMEPOS Competitive Bidding Program, combined with other fraud, waste, and abuse initiatives, is currently saving over $2 billion per year,” said Acting CMS Administrator Dr. Patrick Conway. “During the first three years of competitive bidding in Round 2 areas and the National Mail-Order program for diabetes testing supplies, which began on July 1, 2013, CMS has saved approximately $5.5 billion.” Conway added that monitoring data used to evaluate the effectiveness of the overall competitive bidding program show that implementation is going smoothly, with few inquiries or complaints, without compromising beneficiary health outcomes.

CMS is required by section 1847(b)(3)(B) of the Social Security Act to recompete contracts under the DMEPOS Competitive Bidding Program at least once every three years. Suppliers must then compete to become a Medicare contract supplier by submitting bids to provide certain items in CBAs.

CMS also announced several key updates to the DMEPOS Competitive Bidding Program for Round 2019. For example, CMS is adding insulin pumps and supplies as a product category to be bid in the national CBA. CMS is also adding 10 new CBAs to the program for the Continuous Positive Airway Pressure (CPAP) devices and related accessories product category only. In five of these 10 new CBAs, payment for the CPAP device, related accessories, and services will be made on a bundled, non-capped monthly rental basis, while payment in the other five CBAs will be made on a capped monthly rental basis like all other existing CBAs.

CMS is also including a lead item bidding methodology for certain items in Round 2019 in which suppliers will bid for a lead item within a grouping of similar equipment that takes into account the costs of furnishing all of the equipment in the grouping. The single payment amount for the other items within the grouping will be based on their relative differences in fees when compared to the lead item.

Round 2019 bidders must also obtain a $50,000 bid surety bond for each CBA in which it submits a bid, as required by the Medicare Access and CHIP Reauthorization Act of 2015. Bid surety bonds will be forfeited for bidders who do not accept a contract for a competition (CBA and product category combination) in which the bidder’s composite bid for the competition is at or below the median composite bid rate for all bidding entities included in the calculation of the single payment amounts within the competition.

The Competitive Bidding Implementation Contractor (CBIC) is the official information source for bidders and the focal point for bidder education. The CBIC website, www.dmecompetitivebid.com, features important and helpful resources to ensure that suppliers have the information necessary to understand the new bidding rules and prepare for Round 2019. CMS has provided detailed fact sheets on the CBIC website and will be offering additional educational tools in the future as bidding registration occurs in the spring of 2017. To sign up to receive important competitive bidding announcements and reminders, suppliers are encouraged to subscribe to E-Mail Updates on the CBIC website.

In addition to viewing the information on the CBIC website, suppliers are encouraged to call the CBIC customer service center toll-free at 1-877-577-5331 between 9 a.m. and 5:30 p.m. prevailing Eastern Time with questions.