LOS ANGELES — In a press conference held earlier today, the U.S. Department of Health and Human Services and the Centers for Medicare and Medicaid Services announced the expansion of Medicare's DMEPOS national competitive bidding program.
The extended bidding program is "designed to help lower Medicare beneficiaries' out-of-pocket costs and reduce fraud and abuse while improving access to high-quality durable medical equipment, prosthetics, orthotics and supplies," according to HHS.
"Competitve bidding means that Medicare beneficiaries will have access to these products at lower costs," said CMS Acting Administrator Kerry Weems. "All successful bidders will be required to meet quality standards and be accredited by Medicare. People with Medicare ... will be assured of access, low prices and high quality.
"Through the certification process, beneficiaries will be given another layer of protection from fraud," Weems continued. "We welcomed this program when it was created by the Congress because we believed it could help lower costs for our beneficiaries and help us in our efforts to keep the small number of dishonest providers from taking advantage of American seniors."
Once competitive bidding is fully implemented, Weems said, "we expect that it will save Medicare beneficiaries and the Medicare program about $1 billion a year. By replacing the current fee schedule payment amounts for these items and supplies, which in many cases are significantly higher than market prices with the payment amounts currently determined by the fee-setting process ... competitive bidding provides a way to harness the marketplace, in which suppliers will provide items and services in an efficient manner and at a reasonable cost to our beneficiaries."
Weems said CMS' experience with competitive bidding demonstrations in Florida and San Antonio, Texas, which concluded in 2002, "reached an overall savings of nearly 20 percent in each project, without impairing beneficiary access and while improving quality.
"We expect that the program will defer fraud by eliminating those providers from the competitive bidding program, because suppliers will have to be accredited by the Medicare program. Suppliers will need to meet the high quality standards," he said.
Weems also noted it is important for suppliers who want to participate in Round Two of bidding "to apply for their accreditation as soon as possible to make sure that they have adequate time to be evaluated."
CMS recently announced the final deadline for all suppliers to obtain accreditation is Sept. 30, 2009. However, the agency noted in a release subsequent to today's press briefing that suppliers participating in the second phase of the competitive bidding program will have to be accredited "well in advance of that deadline to be awarded a contract with CMS."
With winners from Round One of the bidding project not yet announced--that is expected in March--NCB's next round will add 70 competitive bidding areas to the program, including New York, Los Angeles and Chicago. The nation's three largest MSAs were excluded from the initial phase of bidding, which was rolled out in 10 cities in 2007, to simplify the first phase of the program. Pricing from the first round of bidding is currently scheduled to take effect July 1 this year.
Selected based on "a variety of factors, including high price and high utilization," Weems said eight products will be subject to Round Two bidding, including:
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
The MSAs selected for Round Two bidding include:
|
West Midwest Northeast |
South |
CMS said it expects to begin pre-bidding activities for the second round, such as announcing the specific zip codes that constitute the CBAs, specific items in each product category and bidder education and registration for user IDs and passwords, in the spring of 2008.
According to the agency, the bidding period is expected to run 60 days and is planned to begin in the summer of 2008. CMS said a more detailed timeline will be provided as the pre-bidding activities begin.
A full announcement about Round Two of the Medicare DMEPOS competitive bidding program can be found at www. cms.hhs.gov/CompetitiveAcqforDMEPOS.
For continuing coverage of competitive bidding, check future issues of HomeCare Monday.