November 17 Deadline Looms for Round 1 Providers

BALTIMORE — A multi-slide presentation held Monday
afternoon (available for download as a PDF) and aimed at
Round 1 providers who failed to win a
competitive bidding contract yielded a lot of information
— but a super-tight deadline to make crucial decisions.
Specifically, non-contract suppliers must determine if they are
willing and able to be grandfathered suppliers no later than
Wednesday, Nov 17. If they choose not to be a grandfather supplier,
they must also notify beneficiaries by that deadline — and
begin to transfer business to contracted DMEPOS competitive bidding
providers.

A non-contract supplier who decides not to take the
grandfathering route must pick up rental equipment from the
patient’s home after sending notifications that meet strict CMS
guidelines. Proper notification includes a 30-day, 10-day, and
finally a two-day notice reiterating the supplier’s decision to
forego grandfather status. The first 30-day notification must be
sent by Nov. 17, and it must be in writing.

Directions for notifying beneficiaries can be
found on the Competitive Bidding Implementation Contractor (CBIC)
website.

CMS’ call was the first of several that have been scheduled,
with the remaining calls for referral agents in the Round 1 CBAs
and contract winners:

• Referral agents – Tuesday, Nov. 16. For
  details, go to http://www.cms.gov/DMEPOSCompetitiveBid/01A1_Announcements_and_Communications.asp#TopOfPage

• Contract suppliers, Part 1 – Wednesday, Nov.
  10. For information and registration instructions, go to
  http://www.dmecompetitivebid.com/palmetto/CBIC.nsf/whatsnew/8AWS6S5427?Open&cat=What’s%20New

• Contract suppliers, Part 2 – Wednesday, Nov.
  17. Registration instructions will be available in the
  days to come. Check the CBIC website under “What’s New.”

According to information on Monday’s 90-minute call, bidders who
failed to win contracts can call the CBIC (877/577-5331) for an
explanation. Officials set Friday, Nov. 19, as the final day for
such inquiries. If mistakes were made, CMS’ Martha Kuespert, senior
technical advisor of the Chronic Care Policy Group, indicated that
contracts could still be awarded.

Suppliers that elect to become grandfathered suppliers are also
bound by the Nov. 17 deadline and must notify current Medicare
beneficiaries with a written notice. The notice must include: all
grandfathered items; the beneficiary’s right to choose; the
supplier’s contact information; and 1-800-MEDICARE or www.medicare.gov
references for questions.

Sample notification letters are also available on the CBIC
website. Providers must properly document the beneficiary’s
decision, and Kuespert reminded callers not to assume that
beneficiaries wish to remain as a customer/patient. 

While the call included information and instructions on various
aspects of the bidding program — CMS received over 100
questions in advance of the call — only a 10-minute period
was reserved for live phone calls. Much of that time was devoted to
a lengthy exchange with Miami provider Rob Brant of City Medical
Services president of the Accredited Medical Equipment Providers of
America.

Brant sought an answer to a specific situation involving
so-called “snowbirds” who travel to Florida during the winter.
Since under grandfathering suppliers must accept assignment for all
patients, for those oxygen patients he is currently billing
unassigned, asked Brant, “What do I tell these patients … Do
I let these patients know I can no longer service you and tell them
‘You need to find another provider willing to take you?’”

Responded CMS’ Joel Kaiser, “When we are talking about
grandfathered items, these are items for which you have a rental
agreement with the beneficiary prior to the start of the
competitive bidding program, so that would be Jan. 1. So if you are
renting an item to a beneficiary who had permanent residence in a
CBA as of Dec. 31 of 2010 — you are currently renting the
item to them now and you are going to be renting to them Dec. 31
— then you need to make the decision.

“When you make the decision to become a grandfathered supplier
for the entire product category for that CBA, if they live in that
CBA, and you are furnishing the item for that beneficiary, you must
grandfather for them as well. You can’t pick and choose patients
for which you are going to grandfather.

“It is all or nothing,” said Kaiser. “You grandfather for all
the patients for that product category and for that area.”

A transcript and audio recording of the Nov. 8 call should be
available on the CMS website “in the coming days,” a CMS official
said.

Fact sheets referenced on the call, including a
fact sheet on grandfathering, are available on CMS’ website.

View more competitive bidding
stories.

Resources

CMS Website: www.cms.gov/dmeposcompetitivebid

Competitive Bidding Implementation Contractor (CBIC) Customer
Service Center: (877) 577-5331
Competitive Bidding Program (CBIC) Website: www.DMECompetitiveBid.com

NSC Website: www.PalmettoGBA.com/NSC