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What You Should Know about the Competitive Bidding Program

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What You Should Know about the Competitive Bidding Program

By Sarah Murphy

On January 1, 2019, the durable medical equipment (DME) competitive bidding program (CBP) temporarily ended so that CMS can make much-needed changes to the program that will presumably improve patient access to equipment and services.

 

What is the competitive bidding program?

The bidding program was authorized by Congress through the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA). It was originally designed to reduce out-of-pocket expenses and help ensure that people with Medicare had access to quality DME, supplies, and services from suppliers they could trust. 

Under this program, a competition among suppliers who operate in a particular competitive bidding area is conducted. Suppliers are required to submit a bid for selected products through a web-based application process. Medicare evaluates bids based on the supplier's eligibility, financial stability and bid price. Contracts get awarded to the Medicare suppliers based on several factors, including price. 

 

What does it mean that the CBP has temporarily ended?

During the temporary CBP break, there will be no contract suppliers. This means that the beneficiary can get DME from any supplier who is enrolled in Medicare and accepts Medicare assignment of benefits. Most beneficiaries will not need to switch suppliers and can continue to use the same supplier they used in 2018.

 

What does this mean for Oxygen One? 

Here's what you should know:

  • There will be a 2 year gap period for CBP. It is not going away and will likely resume sometime in 2021. 
  • We will no longer be accepting non-respiratory referrals (i.e. walkers, wheelchairs), we will care coordinate with any DME referrals made and transition them to another provider. 
  • We will continue to service Medicare patients throughout our service area that require Oxygen, PAP, Nebs, and other respiratory equipment. 
  • We are aware of other providers who have made the choice to stop accepting Medicare assignment for certain items.

Let us know if you have any questions!

Sources:

DME CBP Education

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