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LATEST NEWS: GET READY FOR COMPETITIVE BIDDING! The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), enacted on July 15, 2008, made limited changes to the Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program, including a requirement that competition to re-bid Round 1 occur in 2009. On January 16, 2009, the Centers for Medicare & Medicaid Services (CMS) issued an interim final rule with comment period that incorporates into regulations only those provisions of MIPPA related to the DMEPOS competitive bidding program that are self-implementing and necessary to conduct the Round 1 rebid competition in 2009. That rule became effective on April 18, 2009. To ensure that suppliers have ample time to prepare for the competition, CMS has announced the following next steps for the program: SPRING 2009 - CMS BEGINS PRE-BIDDING SUPPLIER AWARENESS CAMPAIGN
- PROGRAM ADVISORY AND OVERSIGHT COMMITTEE (PAOC) MEETING (JUNE 4, 2009)
http://www.cms.hhs.gov/DMEPOSCompetitiveBid/PAOCMI/itemdetail.asp?filterType=none&filterByDID=-99&sortByDID=1&sortOrder=descending&itemID=CMS1222395&intNumPerPage=10
SUMMER 2009 - CMS ANNOUNCES BIDDING SCHEDULE/SCHEDULE OF EDUCATION EVENTS
- CMS BEGINS BIDDER EDUCATION CAMPAIGN
- BIDDER REGISTRATION PERIOD TO OBTAIN USER IDS AND PASSWORDS BEGINS
FALL 2009 If you are a supplier interested in bidding, prepare now – don't wait! - UPDATE YOUR NSC FILES: DMEPOS supplier standard # 2 requires ALL suppliers to notify the National Supplier Clearinghouse (NSC) of any change to the information provided on the Medicare enrollment application (CMS-855S) within 30 days of the change. DMEPOS suppliers should use the 3/09 version of the CMS-855S and should review and update:
- The list of products and services found in section 2.D;
- The Authorized Official(s) information in sections 6A and 15; and
- The correspondence address in section 2A2 of the CMS-855S.
This is especially important for suppliers who will be involved in the Medicare DMEPOS Competitive Bidding Program. These suppliers must ensure the information listed on their supplier files is accurate to enable participation in this program. Information and instructions on how to submit a change of information may be found on the NSC Web site (http://www.palmettogba.com/nsc) and by following this path: Supplier Enrollment/Change of Information/Change of Information Guide. - GET LICENSED: Suppliers submitting a bid for a product category in a competitive bidding area (CBA) must meet all DMEPOS state licensure requirements and other applicable state licensure requirements, if any, for that product category for every state in that CBA. Prior to submitting a bid for a CBA and product category, the supplier must have a copy of the applicable state licenses on file with the NSC. As part of the bid evaluation we will verify with the NSC that the supplier has on file a copy of all applicable required state license(s).
- GET ACCREDITED: CMS would like to remind DMEPOS suppliers again that time is running out to obtain accreditation by the September 30, 2009 deadline or risk having their Medicare Part B billing privileges revoked on October 1, 2009. Accreditation takes an average of 6 months to complete. It is very important for DMEPOS suppliers to contact an accreditation organization right away to obtain information about the accreditation process and submit an application. Suppliers must be accredited for a product category in order to submit a bid for that product category. CMS cannot contract with suppliers that are not accredited by a CMS-approved accreditation organization.
Further information on the DMEPOS accreditation requirements along with a list of the accreditation organizations and those professionals and other persons exempted from accreditation may be found at the CMS website: http://www.cms.hhs.gov/MedicareProviderSupEnroll/01_Overview.asp . - GET BONDED: CMS would like to remind DMEPOS suppliers that certain suppliers will need to obtain and submit a surety bond by the October 2, 2009 deadline or risk having their Medicare Part B billing privileges revoked. Suppliers subject to the bonding requirement must be bonded in order to bid in the DMEPOS competitive bidding program. A list of sureties from which a bond can be secured is found at the Department of the Treasury's "List of Certified (Surety Bond) Companies;" the web site is located at: http://www.fms.treas.gov/c570/c570_a-z.html.
In the coming months, announcements and updates containing important information about the DMEPOS Competitive Bidding Program will be provided on this web site and on the CBIC website.
Medicare Announces New PAOC and Publication of Interim Final Rule The Centers for Medicare & Medicaid Services (CMS) has announced the appointment of new members to serve on the Program Advisory and Oversight Committee (PAOC) for the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) competitive bidding program. These new members will advise CMS as it proceeds with the restart of the competitive bidding program. The list of PAOC members is available at http://www.cms.hhs.gov/DMEPOSCompetitiveBid/downloads/paoc_member_list.pdf. CMS has also announced an interim final rule with comment period (IFC) implementing certain limited changes, required by the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), to the DMEPOS competitive bidding program. The rule may be viewed at http://edocket.access.gpo.gov/2009/pdf/E9-863.pdf. This IFC addresses the MIPPA provisions that affect Round 1 of the DMEPOS competitive bidding program. In particular, it announces the delay of Round 1 of the program from 2007 to 2009. The 2009 Round 1 competition, also known as the Round 1 rebid, will occur in the same metropolitan statistical areas (MSAs) as the 2007 Round 1 bidding, excluding Puerto Rico. The product categories for 2009 will be the same as those selected for the 2007 Round 1 bidding, with the exception of negative pressure wound therapy (NPWT) and Group 3 complex rehabilitative wheelchairs. To view the CBAs/Product Categories, click on the "Product Categories, Items, and HCPCS" link in the left menu. Group 3 complex rehabilitative wheelchairs are also excluded from all subsequent rounds of competition. The IFC also announces the delay of Round 2 of the program from 2009 to 2011, the national mail order program until after 2010 and competition in additional areas, other than mail order, until after 2011. In addition to the delay of the competitive bidding program, the IFC implements the MIPPA process for providing feedback to suppliers regarding missing financial documentation. Suppliers that submit financial documents within a specified time period known as the covered document review date will be notified by CMS regarding any missing financial documentation. If a bidder is notified, it has ten business days to submit the proper information to CMS. This notice only applies to the receipt of the financial documents. It does not include a review of the accuracy of the documents submitted or whether the documents meet applicable requirements. The requirements for bid application will be detailed in the request for bids (RFB). The IFC also implements the MIPPA provision requiring DMEPOS suppliers that are awarded a contract under the program to disclose information to CMS on each subcontracting relationship. While contract suppliers may use subcontractors for certain limited services, the contract suppliers retain responsibility for ensuring that all services under their contracts are appropriately furnished. Contract suppliers must also provide information on whether each subcontractor meets the applicable accreditation requirements. The statute requires that this information be provided to CMS within a specified timeframe. Lastly, the IFC implements the MIPPA exemption for hospitals that provide certain types of durable medical equipment (DME). Specifically, hospitals are exempted from the competitive bidding program when they provide certain types of DME items, like crutches, walkers, and canes, to their own patients during an admission or on the date of discharge. Suppliers wishing to participate in the Round 1 rebid, including those CMS contract suppliers that were awarded contracts in the delayed Round 1, will need to submit a new bid application in the Round 1 rebid. As in the 2007 Round 1 program, suppliers will be required to meet all applicable eligibility, financial, quality and accreditation standards. The MIPPA changes that are addressed in this IFC do not alter the fundamental requirements of the final regulation for the competitive bidding program published on April 10, 2007. There are other MIPPA provisions that affect later rounds of the competitive bidding program that will be addressed in future rulemaking or program guidance.
PROGRAM OVERVIEW Section 302 of the Medicare Modernization Act of 2003 (MMA) established requirements for a new competitive bidding program for certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS). The MMA requires that competitive bid payment amounts be used to replace the current Medicare DMEPOS fee schedule payment amounts for selected items in selected areas. The competitive bid payment amounts are determined by using bids submitted by DMEPOS suppliers. The intent of the competitive bidding program is to set more appropriate payment amounts for DMEPOS items, which will result in reduced beneficiary out-of-pocket expenses and savings to taxpayers and the Medicare program. Note that all suppliers must be accredited by October 01, 2009. For more information on accreditation, please visit the CMS Medicare Provider-Supplier Enrollment Accreditation page, which can be found under the "Related Links Inside CMS" section below.
Page Last Modified: 06/18/2009 10:16:41 AM
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