CMS Announces New Single Payment Amounts for DMEPOS

Written by: Rebecca Bowden on Monday, March 21, 2016 Posted in: HME/DME

CMS Announces New Single Payment Amounts for DMEPOSOn March 15, the Centers for Medicare and Medicaid Services (CMS) announced new single payment amounts for durable medical equipment, prosthetics, orthotics and supplies (DMEPOS). Since the change to the competitive bidding program, CMS estimates that Medicare saved approximately $3.6 billion (from 2013 and 2015). Prior to competitive bidding, Medicare paid for supplies using a fee schedule based on prices from the 1980s. According to CMS, studies showed this fee schedule to be excessive.

While the competitive bidding program saves Medicare money, does it help suppliers, including those with small businesses? How can smaller providers effectively compete with pricing that is determined by Medicare when the larger suppliers typically win the contracts?

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CMS stated that it will offer 12,181 contracts to 637 round 2 recompete bidders, 56% of whom are small suppliers with gross revenues of $3.5 million or less. CMS also said it will offer nine national mail order contracts, 22% of which are going to small suppliers. Winning bidders will be contracted to supply DMEPOS from July 1, 2016 through December 31, 2018.

Although CMS is reaching out to small suppliers, will these small suppliers still be able to effectively compete? We will see when the contract winners are announced sometime this spring. In the meantime, preview a list of the round 2 product categories and areas below, or click here for more information about the round 2 recompete process.

 

Round 2 Recompete Product Categories and Areas

Enteral nutrients, equipment, and supplies

General home equipment and related supplies and accessories

  • Includes hospital beds and related accessories, group 1 and 2 support surfaces, commode chairs, patient lifts, and seat lifts

Nebulizers and related supplies

Negative pressure wound therapy pumps and related supplies and accessories

Respiratory equipment and related supplies and accessories

  • Includes oxygen, oxygen equipment, and supplies; continuous positive airway pressure (CPAP) devices and respiratory assist devices (RADs); and related supplies and accessories

Standard mobility equipment and related accessories

  • Includes walkers, standard power and manual wheelchairs, scooters, and related accessories

Transcutaneous electrical nerve stimulation (TENS) devices and supplies

 

Source: Centers for Medicare & Medicaid Services; https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-03-15.html

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