BALTIMORE--On Wednesday, CMS posted two new tip sheets related to competitive bidding, one on grandfathering and another for referral agents.
Along with clarifications on questions about picking up equipment if necessary and special payment and billing rules, the tip sheet on grandfathering includes a link to a sample notice that can be used to let beneficiaries know about a provider's decision to become (or not become) a grandfathered supplier.
According to CMS, providers should notify their Medicare patients of this decision in writing "at least 30 days prior to the start date of the competitive bidding program" (in other words, now) in order to give beneficiaries adequate time should they elect or need to transition to a contract supplier by July 1.
According to the tip sheet for referral agents, HME providers, physicians, discharge planners, pharmacists and home health agencies may be a beneficiary's first contact with the competitive bid program, and they may need to direct those patients to a contract supplier. The tip sheet answers a number of FAQs about how to do that.
A DME MAC notice about the referral agent tip sheet gave two examples:
"Medicare patients in the 10 CBAs who use oxygen will need to take action to either transition to a new contract supplier, or, in the case where their current oxygen supplier elects to become a grandfathered supplier, continue services with their current non-contract supplier."
The notice also said "Medicare patients in the 10 CBAs who use enteral nutrients, supplies and equipment must transition to a contract supplier as of July 1, 2008. If they reside in a Skilled Nursing Facility (SNF)/Nursing Facility (NF) that is not a contract supplier, the SNF/NF will have to make new arrangements with a contract supplier to furnish items to their residents. If they live at home, the beneficiary must make new arrangements with a contract supplier."
Both tip sheets can be found on the CMS competitive bidding Web site at www.cms.hhs.gov/DMEPOScompetitivebid. Click on the "Provider Educational Products and Resources" tab and scroll down to the “Downloads” section.