CMS issues list of suppliers contracted with Medicare
■ The first round of a competitive bidding program for durable medical equipment becomes effective on Jan. 1, 2011.
Washington -- The Centers for Medicare & Medicaid Services on Nov. 3 released a list of more than 350 suppliers that have contracts with Medicare to provide medical equipment and supplies to beneficiaries at competitive rates in nine cities across the U.S.
Round 1 of the competitive bidding program for durable medical equipment, prosthetics, orthotics and supplies goes into effect on Jan. 1, 2011, for beneficiaries in Charlotte, N.C.; Cincinnati; Cleveland; Dallas; Kansas City, Mo.; Miami; Orlando, Fla.; Pittsburgh; and Riverside, Calif.
Currently, Medicare pays for DME, including wheelchairs, oxygen equipment, diabetic testing and infusion drug therapy, based on a fee schedule. But in the nine cities, the new program will pay based on rates established under the first round of the competitive bidding program.
Physicians in the nine metro areas included in the first phase of the program may provide walkers to their patients, as that is the only item that falls under the physician exception category. Crutches and canes are not included in the exception category, however. Therefore, if a physician is ordering any items other than a walker, he or she must use a Medicare contract supplier for the item to be covered by Medicare. Physicians can find a list of contract suppliers in each area by product category by visiting the official Medicare website (link).
Doctors should enter the ZIP code included in a competitive bidding area.
CMS officials believe the program will help reduce overall costs and medical equipment billing fraud, as well as ensure that all covered suppliers of the selected equipment categories are legitimate.
"Medicare contract suppliers signed contracts that included terms such as protections to ensure that they will furnish beneficiaries with necessary equipment and quality customer service," said CMS Administrator Donald M. Berwick, MD. "Medicare will hold contract suppliers to their obligations and will take action to address any contract performance problems."
CMS estimates that the program, which Congress authorized, will save Medicare and its beneficiaries nearly $28 billion over 10 years. The agency awarded 1,217 DME competitive bidding program contracts with 356 suppliers. All suppliers were required to comply with Medicare enrollment rules, be licensed and accredited, and meet financial standards.
An additional 91 areas are scheduled to start the bidding program in late 2011 as part of the second round of the program.
The American Assn. for Homecare has opposed the program from the outset, citing "inherent design flaws" that will limit choices and access for DME patients.
In a Nov. 3 statement, the organization said a new study by economists at the California Institute of Technology concluded that the competitive bidding program is based on an "inappropriate architecture that cannot deliver services at competitive rates and qualities."
"This bidding system is really nothing more than a badly designed solution in search of a problem," said Tyler J. Wilson, AAHomecare president. "Medicare patients and providers will pay a steep price if this system goes forward."