Home Health & Hospice

DMEPOS Competitive Bidding Program Explained

Homecare Insider, February 7, 2011

According to the Centers for Medicare and Medicaid Services (CMS), the establishment of the competitive bidding program for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) is designed to reduce out-of-pocket expenses for Medicare beneficiaries and save the Medicare program money while ensuring that beneficiaries continue to receive quality products from accredited suppliers.

The DMEPOS competitive bidding program works like this: suppliers compete to become Medicare contractors by submitting bids to furnish certain medical equipment and supplies in the competitive bidding areas (CBAs). Medicare will use these bids to set a single payment amount that must be lower than the fee schedule amount. Medicare beneficiaries who live in CBAs will then pay less for certain DMEPOS items and services.

Mandated phase-in of this program began, with Round 1, on July 1, 2008 and was followed by a temporary delay, which mandated program modifications and rebids. This phase continued throughout 2009 and 2010 with bid evaluations and supplier competition. The program went into effect in the nine Round 1 rebid areas on January 1, 2011. The supplier competition for the next phase, Round 2, will begin sometime in 2011.

Product categories included in the Round 1 rebid included oxygen supplies and equipment, standard power wheelchairs, scooters and related accessories, complex rehabilitative power wheelchairs and related accessories, mail-order diabetic supplies, enteral nutrients, equipment and supplies, CPAP machines, Respiratory Assist Devices and related supplies/accessories, hospital beds and related accessories, walkers and related accessories, and support surfaces (Group 2 mattresses and overlays in Miami only). With the exception of nursing facilities that become specialty suppliers, contracted suppliers for the enteral product category must furnish services to beneficiaries throughout the CBA, regardless of whether a beneficiary lives in a private residence or institutional setting.

For more information on the DMEPOS competitive bidding program, visit the CMS DEMPOS Competitive Bidding website.