The Centers for Medicare & Medicaid Services (CMS) has added new fact sheets on antitrust guidance, single payment amounts, and commonly owned or commonly controlled suppliers to its growing collection of resources as the agency moves forward with its 2028 round of Medicare competitive bidding for durable medical equipment, prosthetics, orthotics and supplies (DMEPOS).
The new guidance was added on Aug. 13 and published in an MLN Connects newsletter on Aug. 20.
The antitrust guidance warns about the consequences of collusion among bidding suppliers, and instructs suppliers not to enter agreements with competitors to fix bid amounts; not to avoid bidding on a product or area to facilitate a competitor winning a bid; not to take turns being the lowest bidder; and not to share pricing or bidding information with competitors or third parties such as consultants, among other admonitions.
The common ownership and common control guidance states that commonly owned or commonly controlled suppliers are not allowed to compete against each other when bidding. The guidance also defines terms such as “commonly owned,” “ownership interest,” and “commonly controlled.”
The single payment amount guidance explains how CMS will determine the number of competitive bidding contracts to award and how CMS will calculate single payment amounts. The process includes examining total utilization for 2025 of the lead item in the product category).
CMS said it will award 10 competitive bidding contracts in its 2028 round for class II continuous glucose monitors and insulin pumps; 10 contracts for hydrophilic urinary catheters; three contracts for off-the-shelf back braces; four contracts for off-the-shelf knee braces; five contracts for off-the-shelf upper-extremity braces; six contracts for ostomy supplies; and five contracts for urological supplies.
CMS added it “may award additional contracts to account for the number of small suppliers and to ensure beneficiary demand is met” when less than 30% of the initial group of winning suppliers are small suppliers.
