• Monday, July 22, 2013RSS Feed

    DMEPOS Competitive Bidding Program Launched in 91 US Regions

    Physical therapists in 91 metropolitan statistical areas (MSAs) need to know which suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) have been selected by the Centers for Medicare and Medicaid Services (CMS) under its competitive bidding program. As of July 1, these are the only suppliers from which Medicare beneficiaries in these MSAs may obtain certain DMEPOS items, such as wheelchairs, hospital beds, walkers, and oxygen.

    The Medicare.gov website provides a supplier directory under the "Resource Locator" tab for finding a Medicare contract supplier in your region. A Medlearn Matters article (SE1244) and a Fact Sheet from CMS provide more information on this program for physical therapists, physicians, and other providers.

    Under the competitive bidding program, DMEPOS suppliers compete to become Medicare contract suppliers. CMS awards contracts to the suppliers that offer the best prices and meet applicable quality and financial standards. As a result, some DMEPOS suppliers from which your patients have obtained items from in the past may no longer provide these items to Medicare beneficiaries.

    Providers, DMEPOS suppliers, and consumer groups are concerned that the increased emphasis on price competition under this program could produce unsustainably low prices, limit the number of DMEPOS suppliers in the program, and, as a result, reduce beneficiary access to high-quality, brand name, and customizable equipment, and other effective supplies.

    If you experience problems accessing DMEPOS items for your patients, we encourage you to contact APTA by e-mailing advocacy@apta.org. Also, the People for Quality of Care and the American Association for Homecare have set up a hotline at 800/404-8702 for patients and providers to report problems with access to DMEPOS items as a result of this program. The information provided on the hotline will be aggregated and presented to CMS and Congress with the beneficiaries' permission.

    Congress has introduced 2 bills regarding this program: legislation to stop the program altogether and replace it with a market pricing program (HR 1717); and legislation to delay the program for 6 months until various problems can be fixed (HR 2375).


    Comments

    We have limited equipment companies in Honokaa, Hawaii. I work at Hale HoOla Hamakua, a small CAH. Our 2 closest vendors are Aloha Medical and Ban-niks in Kamuela 15miles away. Recently I called Ban-niks for equipment and they stated they were no longer a medicare partipating provider. I called Aloha medical and they did not have the FWW needed in stock. I have gone to our MAC Noridian website to review all compliance requirements to order equipment and it has become extremely challenging to obtain equipment for discharge for out patients. The new requirements for physicians to have one on one is challenging especially when the MDs are looking to the PTs for the proper DME recommendations. I understand concerns with fraud and overutilization, but its seems wasteful to spend hours and hours working on equipment needs, which may delay a paitent's discharge.
    Posted by Sarah Davis on 7/30/2013 2:44 PM
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