HME Business

CMS Releases Round One Bid Amounts

Bid amounts slash reimbursement by an average of 32 percent for some DME.

• By David Kopf
• Jul 01, 2010

CMS has released the winning bid amoutns for the re-bid of Round One of its competitive bidding program, and has said that it has cut funding by an average of 32 percent, accross the different categories and comeptitive bidding areas covered by the program.

To download a PDF table of the single payment amounts per CBA, click here.

The first round of the program is scheduled to begin on Jan. 1, 2011, for beneficiaries in the Charlotte , Cincinnati , Cleveland , Dallas , Kansas City, Miami , Orlando , Pittsburgh and Riverside CBAs. CMS plans to announce the contract suppliers in September once all contracts have been finalized.

CMS said the bid evaluation process ensures that there will be a sufficient number of suppliers, including small suppliers, to meet the needs of the beneficiaries living in the competitive bidding areas. Small suppliers, those with gross revenues of $3.5 million or less, make up about 48 percent of the suppliers that will be offered contracts.

The Round One Rebid includes the same items as the 2008 program except that negative pressure wound therapy items and Group 3 complex rehabilitative power wheelchairs are excluded. These items include:

• Oxygen, Oxygen Equipment, and Supplies

• Standard Power Wheelchairs, Scooters, and Related Accessories

• Complex Rehabilitative Power Wheelchairs and Related Accessories (Group 2 only)

• Mail-Order Diabetic Supplies

• Enteral Nutrients, Equipment and Supplies

• Continuous Positive Airway Pressure (CPAP) Devices, Respiratory Assist Devices (RADs), and Related Supplies and Accessories

• Hospital Beds and Related Accessories

• Walkers and Related Accessories

• Support Surfaces (Group 2 mattresses and overlays in Miami-Ft. Lauderdale-Pompano Beach, FL only)

The agency provided examples of the fee reductions for three example categories covered by the re-bid:

Item/Period of Service	Current Allowed Amount**	New Allowed Amount**	Medicare Savings 80% of Difference	Beneficiary Savings 20% of Difference
Concentrator
Per month	$173.17	$116.16	$45.61	$11.40
Per year	$2,078.04	$1,393.95	$547.27	$136.82
Per 3 years*	$6,234.12	$4,181.84	$1,641.82	$410.46
Hospital Bed
Per month	$127.12	$80.35	$37.42	$9.35
Per 13 months*	$1,334.76	$843.63	$392.91	$98.23
Diabetic Supplies
Per month	$75.32	$33.44	$33.51	$8.38
Per year	$903.87	$401.24	$402.10	$100.53
Per 3 years	$2,711.60	$1,203.72	$1,206.30	$301.58
* Beneficiary takes over ownership of equipment after end of rental payment period ** 20% of current and new allowed amount is paid by the beneficiary out-of-pocket

With the exception of Puerto Rico, the Round One Rebid affects the same areas in which the program was briefly implemented in 2008. These areas are:

• Charlotte – Gastonia – Concord (North Carolina and South Carolina )

• Cincinnati – Middletown (Ohio , Kentucky and Indiana )

• Cleveland – Elyria – Mentor (Ohio )

• Dallas – Fort Worth – Arlington (Texas )

• Kansas City (Missouri and Kansas )

• Miami – Fort Lauderdale – Pompano Beach (Florida )

• Orlando – Kissimmee (Florida)

• Pittsburgh (Pennsylvania)

• Riverside – San Bernardino – Ontario (California)

CMS has already begun emailing notifications to contract winners that they should expect their offers via Federal Express. (Click here to read more.) Bidders that are not offered contracts will be notified of the reasons why they did not qualify for the program when the contracting process is complete. Suppliers that are not contract suppliers for this round of the DMEPOS Competitive Bidding Program may bid in Round Two in 2011 and in future rounds.

MIPPA also required CMS to conduct the competition for the Round One Rebid in 2009, and delayed competition for Round Two in 70 additional metropolitan statistical areas (MSAs) until 2011 and in additional areas of the country until after 2011. The Affordable Care Act of 2010 expands the number of Round Two MSAs from 70 to 91.

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