DMEPOS Competitive Bidding Round 2019 Announced

Breaking News: CMS Announces Temporary Delay of Round 2019

Notice from CMS:
“The Centers for Medicare & Medicaid Services (CMS) has decided to temporarily delay moving forward with the next steps of the Round 2019 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program to allow the new administration further opportunity to review the program. As a result, CMS has removed all information that was released on January 31, 2017, including information on the CMS.gov website and the Competitive Bidding Implementation Contractor (CBIC) website. Please continue to monitor the CMS.gov and CBIC websites for updates.”

This is great news for DME providers as the new administrations has a fresh perspective on these regulations and programs.

VGM will have more commentary and analysis in the coming days.


Original Story (02/07/2017) —–

The Centers for Medicare & Medicaid Services (CMS) announced plans to consolidate all rounds and areas included in the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program into a single round of competition: Round 2019.

The Round 1 2017, Round 2 Recompete and National Mail-Order Recompete contract periods for all product categories will continue through Dec. 31, 2018. Round 2019 contracts are scheduled to be effective for a three-year period from Jan. 1, 2019, through Dec. 31, 2021.

Round 2019 Product Categories

The 11 product categories included in Round 2019 are listed below. New for Round 2019 is the insulin pumps and supplies product category, which will be bid in the national CBA.

  1. Continuous Positive Airway Pressure (CPAP) Devices and Related Accessories (Capped Rental)
    • This product category is only bid in the following five CBAs: Ann Arbor, Mich.; Cedar Rapids, Iowa; Huntsville, Ala.; Salinas, Calif.; Winston-Salem, N.C.
  2. Continuous Positive Airway Pressure (CPAP) Devices and Related Accessories (Non-Capped Rental)
    • This product category is only bid in the following five CBAs: Des Moines-West Des Moines, Iowa; Hickory-Lenoir-Morganton, N.C.; Lansing-East Lansing, Mich.; Mobile, Ala.; Santa Maria-Santa Barbara, Calif.
  3. Enteral Nutrients, Equipment and Supplies
  4. General Home Equipment and Related Supplies and Accessories
    • Includes hospital beds and related accessories, group 1 and 2 support surfaces, commode chairs, patient lifts and seat lifts
  5. Insulin Pumps and Supplies
    • Includes in the national CBA which includes all parts of the U.S., including the 50 states, D.C., Puerto Rico, the U.S. Virgin Islands, Guam, and American Samoa.
  6. Mail-Order Diabetes Testing Supplies
  7. Nebulizers and Related Supplies
  8. Negative Pressure Wound Therapy (NPWT) Pumps and Related Supplies and Accessories
  9. Respiratory Equipment and Related Supplies and Accessories
    • Includes oxygen, oxygen equipment and supplies; continuous positive airway pressure (CPAP) devices and respiratory assist devices (RADs) and related supplies and accessories
  10. Standard Mobility Equipment and Related Accessories
    • Includes walkers, standard power and manual wheelchairs, scooters and related accessories
  11. Transcutaneous Electrical Nerve Stimulation (TENS) Devices and Supplies

A list of the specific items in each product category is available on the CBIC website (www.dmecompetitivebid.com).

Implementation of 10 New CBAs for CPAP Devices and Related Accessories

As noted above, CMS is adding 10 new CBAs specific to the CPAP devices and related accessories product category. No other product category will be subject to competitive bidding in these 10 new CBAs for Round 2019.

In five of the 10 new CBAs – Des Moines-West Des Moines, Iowa; Hickory-Lenoir-Morganton, N.C.; Lansing-East Lansing, Mich.; Mobile, Ala.; Santa Maria-Santa Barbara, Calif. – payment will be made on a bundled, non-capped monthly rental basis, with one monthly rental payment for the CPAP device, related accessories and services for each month of use. No separate payments will be made to suppliers in these CBAs for replacement of equipment, accessories, supplies, repair or maintenance and servicing, including miscellaneous items. Suppliers bidding in these five CBAs will submit bids for a single HCPCS code, K0400.

In the remaining five new CBAs – Ann Arbor, Mich.; Cedar Rapids, Iowa; Huntsville, Ala.; Salinas, Calif.; Winston-Salem, N.C. – payment will be made using the same payment rules for CPAP devices and related accessories in all other existing CBAs. In other words, payment in the remaining five new CBAs will be made for the CPAP device on a capped monthly rental basis, with separate payment on a purchase or rental basis for humidifiers used in conjunction with the CPAP device. Separate payment will also be made for the purchase of essential accessories (such as tubing and masks) and for repair of a beneficiary-owned CPAP device. Suppliers bidding in these five CBAs will submit separate bids to furnish CPAP devices and replacement of related accessories to beneficiaries with a permanent residence in the CBA.

Round 2019: Important Dates

To ensure that suppliers have ample time to prepare for the competition, CMS has announced the following next steps for the program:

January 31, 2017

  • CMS begins pre-bidding supplier awareness program

Spring 2017 (target)

  • CMS announces bidding timeline
  • CMS begins bidder education program
  • Bidder registration period to obtain user ID and passwords begins

Summer 2017 (target)

  • Bidding begins