Competitive Bidding Resource Center |
Welcome to the NHIA member resource center on Medicare competitive bidding, which also includes information on Part B Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) quality standards.
The Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA) requires establishing a competitive bidding program for certain DMEPOS products and services furnished to Medicare beneficiaries under Part B. The Medicare Improvement for Patients and Providers Act of 2008 (MIPPA) amended and added to MMA provisions, including requiring termination of the competitively bid supplier contracts that the Centers for Medicare & Medicaid Services (CMS) had entered into for "Round One" of the program. MIPPA also requires an overall delay of the program and includes a number of provisions intended to fix problems that became visible in the now-postponed roll out of Round One. The MMA gave CMS the authority to establish quality standards and accreditation requirements for all Part B suppliers regardless of their involvement in the competitive bidding program—although CMS had established earlier accreditation deadlines for bidders in the competitive bidding program prior to MIPPA's becoming law. MIPPA included a statutory deadline for all Medicare DMEPOS suppliers to be accredited by October 1, 2009.
Therapies of Primary Interest to NHIA Members. While it is unfortunate that enteral nutrition therapy was included in the first and second rounds of competitive bidding announced prior to the MIPAA delay, it is most important to note that CMS has paid attention to NHIA’s arguments as to why selection of infusion drug therapies would not be appropriate. Of the top ten products CMS had identified for inclusion in the first round for the program in terms of Part B expenditures, the final selected product set comprised all of the top ten except that infusion drugs and pumps (and lower limb Orthotics) were excluded. Infusion drug therapies were also to have been excluded from the second round of the program. Congress considered NHIA arguments when it excluded total parenteral nutrition from competitive bidding in the MMA.
Potential Inclusion of Infusion Drug Therapies. It is still possible that CMS would include Part B-covered infusion drug therapies in competitive bidding in the future. The surest way to solve this pending threat is to get H.R. 2567 passed for a meaningful Medicare benefit for home infusion therapy. Help out now! NHIA also needs significantly increased levels of financial resources to make this happen for you, so please consider our need carefully.
This NHIA member resource center provides educational and reference materials available from NHIA and other sources on the Medicare Part B DMEPOS competitive bidding and quality standards programs, as well as information on new developments in the transition to these programs. Check back periodically for updates to this NHIA resource center.
Tools and Resources
Medicare Part B DMEPOS Quality Standards 