Important New Medicare Information
IMPORTANT NEW MEDICARE INFORMATION
Round Two of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program is targeted to start on July 1, 2013 for people with Original Medicare in 91 areas across the country. This new program will change the amount Medicare pays for certain DMEPOS items and services in your geographic area and will also make changes to which suppliers Medicare will pay to furnish these items. The Centers for Medicare & Medicaid Services (CMS) will be awarding contracts to suppliers for the following categories of DMEPOS:
- Oxygen, oxygen equipment, and supplies;
- Enteral nutrients, equipment and supplies;
- Continuous Positive Airway Pressure (CPAP) devices and Respiratory Assist Devices (RADs), and related supplies and accessories;
- Hospital beds and related accessories;
- Walkers and related accessories;
- Support surfaces;
- Standard power and manual wheelchairs, scooters and related accessories; and
- Negative pressure wound therapy pumps and related accessories.
Medicare will also implement a national mail-order program for diabetic testing supplies at the same time as Round Two. This will change the amount Medicare pays for mail-order diabetic testing supplies and which suppliers Medicare will pay to furnish these supplies. Similar to Round 2, CMS will be awarding contracts for suppliers to provide these supplies. The national mail-order program will include all parts of the United States. This includes the 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, and American Samoa. The target date to implement the new prices and contracts is July 1, 2013.
It is important that physicians, social workers, and discharge planners, understand this new program so that they can help Medicare patients get covered medical equipment and supplies. Once the program begins, patients with Original Medicare who live in or travel to a competitive bidding area and who need any medical equipment/supplies that fall within the product categories listed above will have to get the equipment or supplies from a DMEPOS Medicare contract supplier in order for Medicare to make payment unless an exception applies. Medicare plans to announce the contract suppliers in the spring of 2013.