Competitive Bidding Resource Center

Welcome to the NHIA member resource center on Medicare competitive bidding, which also include 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 MMA also gave the Centers for Medicare & Medicaid Services (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 has established earlier accreditation deadlines for bidders in the competitive bidding program before other suppliers.

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, 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 are also 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

Competitive Bidding Program

Medicare Part B DMEPOS Quality Standards