Reimbursement:
AT-A-GLANCE GUIDE TO COMPETITIVE BIDDING'S PHASE ONE
Published on Mon Mar 05, 2007
Are you in one of the 10 areas bidding will hit first?
Medicare's new DME competitive bidding program is set to roll out in 10 Competitive Bidding Areas (CBAs)--but the list isn't what many expected. Where: The following areas will lead the way into Medicare's new way of pricing and paying for durable medical equipment, prosthetics, orthotics and supplies (DMEPOS): • Miami-Fort Lauderdale-Miami Beach, FL • Charlotte-Gastonia-Concord, NC-SC • Dallas-Fort Worth-Arlington, TX • Orlando-Kissimmee, FL • Riverside-San Bernardino-Ontario, CA • Pittsburgh, PA • Kansas City, MO-KS • Cincinnati-Middletown, OH-KY-IN • San Juan-Caguas-Guaynabo, PR • Cleveland-Elyria-Mentor, OH No surprise: The Centers for Medicare & Medicaid Services excluded the nation's largest Metropolitan Statistical Areas (MSAs)--New York, Los Angeles and Chicago--from the first round of competitive bidding. Each CBA is a geographic region based on the nation's largest MSAs. Many expected Houston to make the list, reports attorney Jeffrey Baird of Brown & Fortunato in Amarillo, TX. Even before the final rule's release, some providers had an inkling of the CBAs to be included. The American Association for Homecare advised members on March 30 that 10 areas were "briefly posted today on the Medicare Competitive Bidding Implementation Contractor (CBIC) website." What: The program will apply initially to 10 categories of DMEPOS, "chosen for a variety of factors, including high price and high utilization," according to CMS. The following items are the first to be competitively bid: • Oxygen supplies and equipment • Standard power wheelchairs, scooters, and related accessories • Complex rehab power wheelchairs and related accessories • Mail-order diabetic supplies • Enteral nutrients, equipment and supplies • Continuous Positive Airway Pressure (CPAP) devices, respiratory assist devices, and related supplies and accessories • Hospital beds and related accessories • Negative Pressure Wound Therapy pumps and related supplies and accessories • Walkers and related accessories • Support surfaces and pressure relieving mattresses (only in the Miami area and Puerto Rico). Note: CMS will hold a special Open Door Forum to discuss the bidding program on April 11 from 2:30--3:30 p.m. EDT. To participate, call 1-800-837-1935 and reference conference ID 2739332. To hear a recording of the ODF, call 1-800-642-1687 and enter the conference ID. The recording will be available from two hours after the call ends and will expire after four business days.
