DMEPOS Competitive Bidding | Centers for Medicare & Medicaid Services

DMEPOS Competitive Bidding

Click here for information on the DMEPOS Competitive Bidding Program Round 1 Recompete.

*For the latest news and information, click on the Latest News and Announcements link on the left side of the page.*
The resources and instructions included throughout these web pages are primarily intended for the Non-Contract Supplier and Referral Agent Community. Medicare beneficiaries may visit www.Medicare.gov to learn more; Bidding and Contract Suppliers should utilize the Competitive Bidding Implementation Contractor (CBIC) website as their primary source of program information (see link the in "Related Links Outside CMS" section below).

CMS DME Referral Agent Electronic Mailing List

Information for people who refer Medicare beneficiaries for durable medical equipment, orthotics and supplies. The DMEPOS Competitive Bidding Program will be changing how some Medicare patients get covered supplies. Be sure to give your Medicare patients the correct information.

PROGRAM OVERVIEW
Section 302 of the Medicare Modernization Act of 2003 (MMA) established requirements for a new Competitive Bidding Program for certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS). Under the program, DMEPOS suppliers compete to become Medicare contract suppliers by submitting bids to furnish certain items in competitive bidding areas, and the Centers for Medicare & Medicaid Services (CMS) awards contracts to enough suppliers to meet beneficiary demand for the bid items. The new, lower payment amounts resulting from the competition replace the Medicare DMEPOS fee schedule amounts for the bid items in these areas. All contract suppliers must comply with Medicare enrollment rules, be licensed and accredited, and meet financial standards. The program sets more appropriate payment amounts for DMEPOS items while ensuring continued access to quality items and services, which will result in reduced beneficiary out-of-pocket expenses and savings to taxpayers and the Medicare program.
Under the MMA, the DMEPOS Competitive Bidding Program was to be phased in so that competition under the program would first occur in 10 areas in 2007. As required by law, CMS conducted the Round One competition in 10 areas and for 10 DMEPOS product categories, and successfully implemented the program on July 1, 2008, for two weeks before the contracts were terminated by subsequent law.
The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) temporarily delayed the program in 2008, terminated the Round One contracts that were in effect, and made other limited changes. As required by MIPPA, CMS conducted the supplier competition again in 2009, referring to it as the Round One Rebid. On January 1, 2011, CMS launched the first phase of Medicare's competitive bidding program in nine different areas of the country for nine product categories.
MIPPA also required the competition for Round Two to occur in 2011 in 70 additional metropolitan statistical areas (MSAs) and authorizes competition for national mail order items and services after 2010. The Affordable Care Act of 2010 expanded the number of Round Two MSAs from 70 to 91 areas and mandates that all areas of the country are subject either to DMEPOS competitive bidding or payment rate adjustments using competitively bid rates by 2016.
CMS is required by law to recompete contracts for the DMEPOS Competitive Bidding Program at least once every three years. The Round One Rebid contract period for all product categories except mail-order diabetic supplies expires on December 31, 2013. CMS is conducting the Round One Recompete in the same competitive bidding areas as the Round One Rebid.

Downloads

Competitive Bidding Update - One Year Implementation Update - April 17, 2012 [PDF, 1022KB]

Home Health, Hospice & Durable Medical Equipment Open Door Forum

**Updated February 5, 2013 - The Durable Medical Equipment, Orthotics and Supplies (DMEPOS) Competitive Bidding Program will be changing how some Medicare patients get covered supplies. Be sure to give your Medicare patients the correct information. Please review (copy and paste the link into your web browser) the following link for information for people who refer Medicare beneficiaries for DMEPOS: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/DMEPOSCompetitiveBid/index.html?redirect=/DMEPOSCompetitiveBid/01_overview.asp .
**Updated January 30, 2013- Attention All Hospice Providers – Action Required by 11:59 PM ET on January 31, 2013
The deadline for submission of structural measure data for the Hospice Quality Reporting Program (HQRP) is 11:59 PM Eastern time, January 31, 2013. Hospice providers that have not already created a user account and begun structural measure data entry should do so immediately. The Hospice Final Rule (August 2011) established that this year is a “pay for reporting” year. This means that hospices will receive an APU reduction based on whether or not they report. Your performance level is not a consideration for APU impact. In practical terms, this means that all hospices, regardless of whether or not they have a QAPI program in place, should submit answers to several questions via the data entry website to satisfy this year’s reporting requirements. Providers that fail to meet BOTH of the required HQRP reporting deadlines (1/31/13 for the structural measure; 4/1/13 for the NQF #0209 Pain Measure) will receive a two percentage point reduction in their 2014 Annual Payment Update (APU).
The link to the data entry site is available on the Data Submission portion of the CMS HQRP website ( http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Hospice-Quality-Reporting/Data-Submission.html ), at the bottom of the webpage, under “Related Links.”

**Updated January 24, 2013 - We are aware that many people were not able to participate during today’s Future Development of the QIO Program Special Open Door Forum due to a limited number of phone lines available. We apologize for this inconvenience. An encore replay of this call will be available beginning today at 4pm ET and will continue until midnight, Friday, January 25, 2013. To access the encore feature, dial: 1-855-859-2056; Conference ID: 90637068. A transcript and copy will also be made available in the coming days and will be posted on our website. You will receive notification when the transcript and audio copy are available on our website. Thank you for your continued interest in the CMS Open Door Forums.
**Updated January 24, 2013 - The slides for today's (12:30pm - 2:00pm ET) Future Development of the Quality Improvement Organization (QIO) Program Special Open Door Forum are now available on our website at http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityImprovementOrgs/Downloads/QIOSODF01-24-13.pdf . If you wish to participate, dial 1-800-837-1935; Conference ID: 90637068. Please see the full participation announcement in the Downloads section below. Thank you for your continued interest in the CMS Open Door Forums.
**Updated January 17, 2013 - The Centers for Medicare & Medicaid Services (CMS) will host a Special Open Door Forum, entitled "Future Development of the Quality Improvement Organization (QIO) Program," on January 24, 2013 from 12:30pm - 2:00pm ET. If you wish to participate, dial 1-800-837-1935; Conference ID: 90637068. Please see the full participation announcement in the Downloads section below. Thank you for your continued interest in the CMS Open Door Forums.
**Updated January 9, 2013 - Urgent Hospice Quality Reporting Registration Information has been added to the Downloads section below. Thank you.
**Updated January 7, 2013 - A reminder that the next Home Health, Hospice & Durable Medical Equipment (DME) Open Door Forum is scheduled for Wednesday, January 9, 2013, from 2:00pm – 3:00pm, ET. If you wish to participate, dial 1-800-837-1935; Conference ID: 78868196. Please see the agenda in the Downloads section below. Thank you for your continued interest in the CMS Open Door Forums.
**Updated January 3, 2013 - The transcript and audio file of the December 19, 2012 Hospice Special Open Door Forum is available on the Special Open Door Forum web page in the Downloads section: http://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/ODFSpecialODF.html . Thank you for your continued interest in the CMS Open Door Forums.
**Updated January 2, 2013 - The next Home Health, Hospice & Durable Medical Equipment (DME) Open Door Forum is scheduled for Wednesday, January 9, 2013, from 2:00pm – 3:00pm, ET. If you wish to participate, dial 1-800-837-1935; Conference ID: 78868196. Thank you for your continued interest in the CMS Open Door Forums.
**Updated January 2, 2013 - CMS Announces 90-Day Period of Enforcement Discretion for Compliance with Eligibility and Claim Status Operating Rules. Please see Downloads section below for full announcement.
**Updated December 17, 2012 - The Centers for Medicare & Medicaid Services (CMS) will host a National Provider Call on the Implementation of Section 3133 of the Affordable Care Act: Improvement to Medicare DSH Payments on Tuesday, January 8, 2013 from 1:30pm - 3:30pm ET. Please see the full announcement in the Downloads section below for registration information. Thank you.
**Updated December 14, 2012 - Please see the "New Electronic Mailing List to Keep Fee-For-Service Providers Informed" announcement in the Downloads section below.
**Updated December 13, 2012 - The Centers for Medicare & Medicaid Services (CMS) will host a Hospice Special Open Door Forum on Wednesday, December 19, 2012 from 1:00pm - 2:00pm ET. If you wish to participate, dial 1-800-837-1935; Conference ID: 81540883. Please see the full participation announcement in the Downloads section below. Thank you for your continued interest in the CMS Open Door Forums.
**Updated December 13, 2012 - The Centers for Medicare & Medicaid Services (CMS) will host a Special Open Door Forum entitled Suggested Electronic Clinical Template for Power Mobility Devices on Wednesday, December 19, 2012 from 4:00pm - 5:00pm ET. If you wish to participate, dial 1-800-837-1935; Conference ID: 69289478. Please see the full participation announcement in the Downloads section below. Thank you for your continued interest in the CMS Open Door Forums.
**Updated December 10, 2012 - Hospice Quality Reporting Program Data Submission Webex is available:
A WebEx training about the web-based data submission is available on the QTSO website. Hospices can access the WebEx at their convenience at: https://www.qtso.com/hospicetrain.html
For the first year of reporting affecting the FY 2014 payment determination, hospices are submitting two measures: The Structural/QAPI measure and the NQF 0209 measure. The data collection period is Oct 1-Dec 31, 2012. The structural measure must be reported by January 31, 2013 and the NQF #0209 by April 1, 2013. Additional information and materials about the hospice quality reporting program are available at: http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Hospice-Quality-Reporting/Spotlight.html
**Updated December 3, 2012 - The transcript and audio file for the October 22, 2012 Manual Medical Review of Therapy Claims Special Open Door Forum is available on the Special Open Door Forum web page: http://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/ODFSpecialODF.html . Thank you for your continued interest in the CMS Open Door Forums.
**Updated November 27, 2012 - The Agenda for the next Home Health, Hospice & Durable Medical Equipment Open Door Forum, scheduled for Wednesday, November 28, 2012, from 2:00pm – 3:00pm, ET, is now available in the Downloads section below. If you wish to participate, dial 1-800-837-1935; Conference ID: 72193272. Thank you for your continued interest in the CMS Open Door Forums.
**Updated November 19, 2012 - The next Home Health, Hospice & Durable Medical Equipment (DME) Open Door Forum is scheduled for Wednesday, November 28, 2012, from 2:00pm – 3:00pm, ET. If you wish to participate, dial 1-800-837-1935; Conference ID: 72193272. Another notification will be sent before the call with the agenda. Thank you for your continued interest in the CMS Open Door Forums.
**Updated November 13, 2012 - CMS has updated Spotlight & Announcements with information about upcoming WebEx training on the Hospice Quality Reporting Program Data Entry and Submission:
CMS has posted information on the Spotlight & Announcement page of the Hospice Quality Reporting website about the upcoming availability of WebEx training for hospices. The training will help hospices prepare for web-based data entry and submission of quality data affecting the FY 2014 payment determination. The WebEx will be available beginning the week of November 12, 2012. Hospices can access additional details about the WebEx here: http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Hospice-Quality-Reporting/Spotlight.html
**Updated September 27, 2012 - The next Home Health, Hospice & Durable Medical Equipment (DME) Open Door Forum is scheduled for Wednesday, October 3, 2012, from 2:00pm – 3:00pm, ET. If you wish to participate, dial 1-800-837-1935; Conference ID: 76245818. Please see the full participation announcement in the Downloads section below. Thank you for your continued interest in the CMS Open Door Forums.
**Updated April 6, 2012 -The Centers for Medicare and Medicaid Services is pleased to announce the scheduled release of modifications to the Healthcare Common Procedure Coding System (HCPCS) code set. These changes have been posted to the HCPCS website at http://www.cms.gov/HCPCSReleaseCodeSets/02_HCPCS_Quarterly_Update.asp . Changes are effective on the date indicated on the update.
In response to shortage of liposomal doxorubicin (Doxil), the FDA is permitting the temporary importation of Lipodox, a brand of liposomal doxorubicin hydrochloride.
See http://www.fda gov/NewsEvents/Newsroom/PressAnnouncements/ucm292658.htm . The Centers for Medicare and Medicaid Services’ (CMS) HCPCS Quarterly update includes 2 new codes (Q2048 and Q2049) for liposomal doxorubicin that will become effective July 1, 2012. The code descriptors are worded in a manner that distinguishes Lipodox and Doxil. As of July 1, 2012, HCPCS code J9001 will not be used for Medicare billing. CMS will release a Change Request (CR) with additional instructions in the near future.
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Home Health, Hospice, and Durable Medical Equipment Open Door Forum (ODF) Overview:
The Home Health, Hospice & Durable Medical Equipment ODF addresses the concerns of three unique health care areas within the Medicare & Medicaid programs. Issues related to Home Health PPS, the newly proposed competitive bidding for DME, and the Medicare Hospice benefit are all topics the forum has covered. Many of the issues covered bridge concerns within all three settings, and the combination of the topics under one Forum has been useful to many participants. We continue to hold Special ODFs when individual policy issues require special attention. Timely announcements and clarifications regarding important rulemaking, agency program initiatives, and other related areas are also included in the forums.