The Centers for Medicare and Medicaid Services (CMS) released their preliminary list of product categories that will be part of Round 2 Durable Medical Equipment, Prosthetics, Orthotics Supplies (DMEPOS) Competitive Bidding Program beginning in the summer of 2013. Round 1 of DMEPOS Competitive Bidding was implemented in 9 large metropolitan areas (Charlotte, NC; Kansas City, MO; Riverside, CA; Cleveland and Cincinatti, OH; Miami and Orlando, FL; Pittsburgh, PA; Dallas, TX) on January 1st, 2011. Round 2 is scheduled to include an additional 91 metropolitan areas and include the following bid categories for DMEPOS suppliers:
- Oxygen Supplies and Equipment
- Standard (Power and Manual) Wheelchairs, Scooters, and Related Accessories
- Enteral Nutrients, Equipment and Supplies
- Continuous Positive Airway Pressure (CPAP), Respiratory Assist Devices (RADs), and Related Supplies and Accessories
- Hospital Beds and Related Accessories
- Walkers and Related Accessories
- Support Surfaces (Group 2 mattresses and overlays)
- Negative Pressure Wound Therapy (NPWT) Pumps and Related Supplies and Accessories
As you can see, no orthotics or prosthetics products/supplies were added to the Round 2 DMEPOS Competitive Bidding product categories list. As one of the top 10 most commonly billed products currently not included in the controversial DMEPOS program, off-the-shelf orthotics had been rumored to be included in Round 2 Competitive Bidding. In addition to the off-the shelf products, last month CMS provided congress with a list of over 100 mostly prefabricated O&P devices that were considered outside of the statutory definition of off-the-shelf orthotics with a value of over $200 million that CMS was considering including in Round 2 of DMEPOS Competitive Bidding. AOPA President Tom Dibello led several meetings with CMS officials detailing the importance of off-the-shelf orthotics and also explaining how these additional devices did not fit the off-the-shelf definition leading up to the release of the Round 2 categories last week.
While O&P were not added to Round 2, there were several other additions including standard manual wheelchairs and negative pressure wound therapy and supplies. Rest assured that custom orthotics and prosthetics cannot be included in DMEPOS Competitive Bidding without additional congressional action, but products like off-the-shelf orthotics could be added in future bid rounds if CMS deems it necessary.
For more information on products that are included in Round 2 Competitive Bidding for DMEPOS, click here.