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What’s the Deal with CMS’ DMEPOS Competitive Bidding Program?!?!?

By: Michael Silvermanfhlf dmepos competitive bidding

Round 2021 of Medicare’s DMEPOS Competitive Bidding (“CBID”) Program has been a doozy to say the least!

From the complexities of the new bidding process announced in 2019 that I initially wrote here and on this article through the uncertainty regarding whether Round 2021 would ultimately be implemented given the COVID-19 pandemic, the Round 2021 CBID Program that goes into effect on January 1, 2021 is shaping up to be much different than originally anticipated. Allow me to breakdown the changes between ‘then’ and ‘now’:

Video on Round 2021 of Medicare’s DMEPOS Competitive Bidding (“CBID”) Program.

  • Round 2021 CBID Program originally encompassed 16 DMEPOS product categories across 130 competitive bidding areas pertaining to Medicare Part B beneficiaries, and ‘bids’ were submitted by DMEPOS providers Fall 2019;
  • In April 2020, with the ongoing COVID-19 pandemic, Medicare removed one product category from the Round 2021 CBID Program, non-invasive ventilators;
  • Since then – with the ongoing pandemic – there has been extreme uncertainty surrounding whether Round 2021 CBID Program would even move forward at all; there has been active industry lobbying to Congress to delay its implementation.
  • On October 27, 2020 it was announced that, of the remaining 15 product categories included within Round 2021 CBID Program after the removal of non-invasive ventilators, only 2 product categories – OTS knee and back braces – would remain once implemented on January 1, 2021.
  • Additionally, of the 130 competitive bidding areas that were ‘bid’ out for those two product categories, 127 areas in total were awarded (3 of the originally bid areas were not ultimately included).
  • DMEPOS Providers who submitted bids were notified at the end of October, as were those Providers who were disqualified.

In Sum: Round 2021 CBID Program – pertaining to 2 product categories across 127 competitive bid areas – goes into effect on January 1, 2021. What does that mean for Medicare enrolled DMEPOS providers? Essentially, they can only service a Medicare beneficiary that resides in a competitive bid area with competitively bid product IF they have been awarded a ‘bid’ by Medicare.

How does Medicare’s Round 2021 CBID Program impact your DMEPOS business, if at all? What are provider’s options in moving forward? We are always here to help.