DMEPOS Competitive Bidding Program and New Regulations

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• DMEPOS Competitive Bidding Program and New
  Regulations

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DMEPOS Competitive Bidding Program and New
Regulations

• DEMPOS stands for Durable Medical Equipment,
  Prosthetics, Orthotics, Supplies (DMEPOS). The
  DEMPOS competitive bidding program was set by the
  Medicare Prescription Drug, Improvement, and
  Modernization Act of 2003 (MMA). In order to
  become Medicare contract suppliers, under the
  DMEPOS Competitive Bidding Program, DMEPOS
  suppliers compete with each other by submitting
  bids to provide certain items in competitive
  bidding areas (CBAs). The act requires that
  single payment amounts (SPAs) substitute the
  current Medicare DMEPOS fee schedule payment
  amounts for preferred DMEPOS items in specific
  areas of the country. The SPAs are found out with
  the help of bids submitted by DMEPOS suppliers.
• For Medicare objective, durable medical equipment
  (DME) known for equipment that
• Can endure multiple usages
• Is used primarily and customarily to cater a
  medical purpose
• Generally is not helpful to a person in the
  healthy condition
• Is convenient for home usage
• The DMEPOS Competitive Bidding Program has been
  an important instrument to support Medicare set
  market-based payment rates for DMEPOS items.
  Additionally, this helps to prevent the abuse as
  well as fraud in Medicare and also saves money
  for taxpayers and beneficiaries. Since its
  implementation, the program has saved billions of
  dollars, although providing access to quality
  services and products.

Medical Billing Services in Oregon
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DMEPOS Competitive Bidding Program and New
Regulations

• The DEMPOS Competitive Bidding Program contract
  was expired in December 2018 and from January 1,
  2019, there is a momentary gap in the program
  that Centers for Medicare Medicaid Services
  (CMS) expects will last till December 2020.
  Though there is a temporary gap CMS has come up
  with round 2021 updates. Some of the round 2021
  updates are as follows.
• CBAs
• CMS is centralizing the CBAs, which were added in
  Round 1 2017 and Round 2 Recompete by conducting
  Round 2021 in the same geographic areas for a
  total of 130 CBAs.
• Product Categories
• CMS is transferring some items to various smaller
  product categories to include the lead item
  pricing methodology. There are about 16 types of
  products, which are included in Round 2021 are as
  follows.
• Enteral Nutrition
• Commode Chairs
• Negative Pressure Wound Therapy (NPWT) Pumps
• OTS Back Braces
• Transcutaneous Electrical Nerve Stimulation
  (TENS) Devices
• Hospital Beds

Medical Billing Services in Oregon
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DMEPOS Competitive Bidding Program and New
Regulations

• Patient Lifts and Seat Lifts
• Walkers
• Standard Manual Wheelchairs
• Nebulizers
• Standard Power Mobility Devices
• Continuous Positive Airway Pressure (CPAP)
  Devices and Respiratory Assist Devices (RADs)
• Non-Invasive Ventilators
• OTS Knee Braces
• Oxygen and Oxygen Equipment
• Support Surfaces (Groups 1 and 2)
• Apart from above mentioned updated there are
  around eight more updates such as lead item
  pricing, national mail-order, essential financial
  documents evaluation, single payment amounts, bid
  surety bonds, review of bid disqualification,
  licensure and accreditation requirements for
  bidders, and round 2021 precluded suppliers.

Medical Billing Services in Oregon