Competitive Bidding Resource Center

Welcome to the NHIA member resource center on Medicare competitive bidding.

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 required an overall delay of the program and included a number of provisions intended to fix problems that became visible in the now-postponed roll out of Round One.  On January 15, 2009, CMS announced the resumption of the program with issuance of an interim final rule which went into effect on April 18, 2009 that incorporates the MIPPA requirements.  CMS opened re-bidding for Round One on October 21, 2009 which closed on December 21, 2009.  There will be a prolonged period after bidding leading to implementation in January 1, 2011.

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 ensure this does not happen is to get Medicare legislation passed for a meaningful Medicare benefit for home infusion therapy. Help out now!

Quality Standards/Accreditation.  Most Part B DMEPOS suppliers must have been accredited for DMEPOS by October 1, 2009.  This requirement is independent of any developments with or participation in the competitive bidding program.  Learn more at NHIA's Medicare Accreditation Resource Center.

 

Tools and Resources

Medicare DMEPOS Competitive Bidding Program