Yesterday the Centers for Medicare & Medicaid Services unveiled plans for the next round of the competitive bidding program moving into 2019. In an announcement, CMS outlined the consolidation of former rounds including Round 1, 2017, Round 2 Recompete, and the National Mail-Order contracts into one single round named Round 2019. All current contracts will continue through Dec. 31, 2018 as the Round 2019 will immediately take effect beginning Jan. 1, 2019 through Dec. 31, 2021.
There are a number of changes to the program including:
New CPAP Specific CBAs
- As stated above, Round 2019 will consolidate to take place in 141 CBAs, which can be viewed here. This considlation will also include 10 new CBAs that have a specific CPAP device and accessory product category. These new CBAs have not been included in any previous competitive bidding rounds.
- New CPAP-only CBAs include: Alabama – Mobile and Hunstville, California – Santa Maria-Santa Barbara and Salinas, Iowa – Des Moines-West Des Moines and Cedar Rapids, Michigan – Lansing-East Lansing and Ann Arbor, North Carolina – Hickory-Lenior-Morganton and Winston-Salem
Click here to view CMS Fact Sheet regarding CPAP CBAs
- “In the five (5) new CPAP non-capped rental CBAs, payment will be made for the CPAP device, related accessories, and services (e.g., delivery, set-up, training/instruction, repair and maintenance) on a bundled, noncapped monthly rental basis. No separate payments will be made to suppliers in these CBAs for replacement of equipment, accessories, or supplies, repair, or maintenance and servicing related to a CPAP device and its accessories; including parts billed using codes for miscellaneous items (e.g., E1399). “
- For the remaining five new CBAs, payments will be made on a capped monthly rental basis. “These are the same capped rental payment rules that apply to CPAP devices and related accessories in Round 2 Recompete and Round 1 2017.” All other Round 2019 CBAs will follow the same capped rental payment rules as before.
Lead Item Bidding
- CMS has established six groups of related equipment, hospital beds, seat lifts, support surface mattresses, TENS devices, walkers, and standard power wheelchairs. “Under the lead item bidding methodology, the competitively bid lead item is described by a combination of HCPCS codes. Suppliers will submit one bid for furnishing the lead item HCPCS code (e.g., E0260 for hospital beds). Bids for the lead item in a grouping will be used to determine the SPAs for the rest of the items within that grouping (e.g. 15 other HCPCS codes describing similar hospital beds).”
Click here to view more on Lead Item Bidding
Bid Surety Bonds
- Bidders must obtain a $50,000 bid surety bond from an authorized surety on the Department of the Treasury’s Listing of Certified Companies for each CBA for which a bid is submitted. A copy of the bid surety bond(s) must be uploaded to the DMEPOS Competitive Bidding Program’s secure online portal, Connexion, by the deadline for bid submission.
CMS has not released a timeline for bidding yet, but it can be expected to be announced sometime this spring and bidding will likely begin in summer 2017.