WASHINGTON—The Competitive Bidding Program (CBP) for durable medical equipment should restart in 2028, according to a final rule published by the Centers for Medicare & Medicaid Services (CMS) on Friday.
The proposed rule included significant changes to the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) bidding program. It also alters the supplier accreditation process, reduces home health agency payment rates under Medicare and more.
Reviving the competitive bidding program and expanding it to include diabetes equipment as well as ostomy, urological and tracheostomy supplies will further burden an already stressed home medical equipment sector, said Tom Ryan, president and CEO of the American Association for Homecare (AAHomecare).
“Smaller, community-based suppliers will be hit particularly hard, and many patients and family caregivers will lose access to highly experienced and trusted partners who have been providing their care,” Ryan said. “A new bidding round without a fair bid-setting mechanism is sure to produce rates that force suppliers to use cheaper, lower-quality products and leave patients with fewer choices. The end result will be higher costs to the Medicare program thanks to increased ER visits and hospitalizations, and more strain on caregivers.”
Changes to the CBP
The new rule lays out a timeline for the bidding program to return and will set final bids at the 75th percentile of winning bids. It requires less financial documentation in the bid submission process than before, according to AAHomecare.
It also adds and alters some product categories, including:
- Adding continuous glucose monitors (CGMs) and reintroducing insulin pumps
- Adding urological, ostomy and tracheostomy supplies
- Changing the payment category for Class II CGMs and insulin pumps to “frequent and substantial servicing” for competitive bid areas and non-competitive bid areas.
Accreditation Changes for DMEPOS
The new rule also establishes that accreditation surveys for DME providers will change from a three-year accreditation cycle to requiring that providers be resurveyed and recredited at least once every 12 months.
Timeline & Categories for the New Round of Competitive Bidding
In a fact sheet, CMS said they plan to have the next bidding round go live no later than January 2028, and said that pre-bidding education will start this month, with the bidding window to open next summer.
Here is a targeted timeline as provided by CMS:
December 2025: CMS begins pre-bidding supplier awareness program
Late Spring/Early Summer 2026: CMS announces specific dates for registration and bidding, announces lead items product categories and number of contracts per category, and begins begins bidder education program
Late Summer/Early Fall 2026: Bidder registration period to obtain user IDs and passwords begins; bid window opens
Late Summer/Early Fall 2027: Contracts awarded and single payment amounts announced; beneficiary education begins
The new round of competitive bidding will include the following remote item delivery product categories:
- Class II Continuous Glucose Monitors (CGMs) and Insulin Pumps
- Urological Supplies[1]
- Ostomy Supplies
- Hydrophilic Urinary Catheters
- Off-The-Shelf (OTS) Back Braces
- OTS Knee Braces
OTS Upper Extremity Braces