CMS Consolidates All Bid Areas Into Single Round

Agency moves to merge Rounds One and Two, as well the mail order competition, into a single competitive bid it calls Round 2019.

The Centers for Medicare and Medicaid Services will consolidate all rounds and bid areas for its Competitive Bidding Program into a single round of competition, which it is calling Round 2019.

Bidding for Round 2019 will begin in the summer of this year, with CMS releasing the Round 2019 timeline and initiating bid registration sometime this spring, according to the "important dates" section of the Competitive Bidding Implementation Contractor (CBIC) website.

After Round One 2017, the Round Two Recompete, and the national mail-order competition conclude on Dec. 31, 2018, the Round 2019 contracts will become effective Jan. 1, 2019, and will run until Dec. 31, 2021.

Additional changes:

  • Round 2019 will include 141 competitive bidding areas, and will cover 11 product categories. Updates to the categories include the addition of insulin pumps and supplies as a product category to be bid in the national CBA.
  • CMS also added 10 CBAs for the CPAP devices and related accessories product category only. In five of these 10 new CBAs, payment for the CPAP device, related accessories, and services will be made on a bundled, non-capped monthly rental basis. In the other five CBAs, payment will be made on a capped rental basis like in the other existing CBAs.
  • Round 2019 will also incorporate a “lead item” bidding methodology into the program for certain items. Under this approach, suppliers will bid for a lead item within a grouping of similar equipment that takes into account the costs of furnishing all of the equipment in the grouping. The single payment amount for the other items within the grouping will be based on their relative differences in fees when compared to the lead item.

CMS will require Round 2019 bidders to obtain a $50,000 bid surety bond for each CBA in which they submit a bid. Per the the Medicare Access and CHIP Reauthorization Act, bidders who do not accept a contract for a competition in which their bid is at or below the median composite bid rate will forfeit their bond.

In CMS's Round 2019 announcement, Acting CMS Administrator Dr. Patrick Conway doubled down on familiar agency rhetoric that the program saves money with few complaints.

“The Medicare DMEPOS Competitive Bidding Program, combined with other fraud, waste, and abuse initiatives, is currently saving over $2 billion per year,” he stated. “During the first three years of competitive bidding in Round Two areas and the National Mail-Order program for diabetes testing supplies, which began on July 1, 2013, CMS has saved approximately $5.5 billion.”  

About the Author

David Kopf is the Editor of HME Business.

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