CMS Delays DME Round 2 Competitive Bidding, Looks to Add Off-the-Shelf O&P

The Centers for Medicare and Medicaid Services (CMS) has decided to delay round two of the controversial “competitive bidding” program for durable medical equipment until the summer of 2013.  Round one of competitive bidding on selected DME products was implemented in nine metropolitan areas on January 1, 2011. Round two was expected to expand to 91 metropolitan areas by the end of 2012.  Officials at CMS will use the additional time to solicit feedback on perceived flaws in the bidding system, look at effects on beneficiary service, and decide which products to include in the second round of bidding.

Round 1 competitive bidding did not include several products that are in the top 10 DME equipment categories, including manual wheel chairs, infusion pumps and off-the-shelf orthotics and prosthetics.  Off-the-shelf O&P are #9 on the list of billed DME caterogies and are seen as a possible addition to Round 2.

OPGA Government Relations will continue to follow the list of products to be included in Round two of competitive bidding and keep you informed on the inclusion of off-the-shelf orthotics and prosthetics.

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2 Responses to CMS Delays DME Round 2 Competitive Bidding, Looks to Add Off-the-Shelf O&P

  1. Why did the first bidding never includes the wheelchairs? What’s the problem?

    • ryanball1 says:

      CMS doesn’t always release information on why they didn’t do something, but the sense is that many manual wheelchairs are sold not just by DME dealers, but also others in the industry such as physicians/physical or occupational therapists/pharmacists/etc., that CMS decided to hold off on manual wheelchairs on Round 1 to measure the impact of the power chair competitive bidding process. CMS is also working on improving coding for manual wheelchairs, but that process has been put on hold, which is what is leading to the speculation that manual wheelchairs will be included in Round 2 competitive bidding.

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