Proposed Rule On DME Bidding Details to Appear This Summer

Baltimore

CMS plans to roll out a massive proposed regulation this summer detailing exactly how DME competitive bidding will be implemented when it begins in 2007. As discussed at past PAOC meetings, here are some questions the proposed draft is expected to answer:

• Where: The program is slated to begin in 10 top metro areas in 2007 and expand into other areas thereafter. What criteria will be used to select these areas? Beginning in 2010, one nationwide competitive acquisition area could be established for some items for which there is a significant national market through mail order, according to CMS.
• What: Which home medical products will be part of the bidding process?
• How: What formula(s) will be used to calculate payments? Will items be bid individually and/or by product categories?
• Who: Aside from quality standards — the draft of those requirements will be released in a separate document — what other prerequisites must providers meet to participate? How will CMS help create a level playing field for small providers? Suggestions have included allowing them to form networks, letting them choose specific sections of a metro area to serve and establishing limited financial standards.