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Fast Facts

DMEPOS competitive bidding process will begin April 2007.
CMS has announced the 10 MSAs where competitive bidding will be introduced.
CMS has announced the product categories included in the first competitive bidding project.
The Final Rule governing competitive bidding ensures that at least 30 percent of bid winners are small businesses.
Suppliers must obtain accreditation to participate in competitive bidding. The ONLY exception to the rule is a pharmacy that maintains a Part B supplier billing number to submit Part B drug claims and administer vaccinations.
Ten agencies have been approved to accredit suppliers of DMEPOS.

Important Links:

Evaluating DMEPOS Bids and Selecting Winners

By William Popomaronis, R.Ph.

As the result of its competitive bidding project, the Centers for Medicare & Medicaid Services (CMS) will establish a "single payment amount" for the items subject to competitive bidding based on the bids submitted. The single payment amount will become the new Medicare payment basis in the competitive bid areas.

Suppliers participating in the competitive bidding process must bid on DMEPOS by product category. CMS will evaluate and take a weighted sum of bids on individual items in each product category. This is the composite bid. By example, if you want to bid on oxygen supplies and equipment, you must submit a bid on every CMS defined item in that product category.

Next, CMS will establish the pivotal bid. The pivotal bid would be the highest composite bid based on bids submitted by suppliers for a product category. The pivotal bid would be the highest composite bid based on bids submitted by suppliers for a product category that includes a sufficient number of suppliers to meet the beneficiary demand for the items in that product category. Everyone at or below the pivotal bid is selected as a winner.

The final rule provides for 30 percent of winning suppliers to be small businesses. If CMS determines after the initial evaluation of bids that there are not enough small suppliers with winning bids to meet the target goal of 30 percent in each product category, then contracts will be offered to small suppliers that submitted bids higher than, but close to the winning bids. The small suppliers will have the option to accept the single payment amounts based on the winning bids until the 30 percent goal is met or there are no more small suppliers.

William Popomaronis, R.Ph., is vice president, long term and home health care services for the National Community Pharmacists Association (NCPA). He is also the only pharmacist member of Medicare’s Program Advisory and Oversight Committee (PAOC), which provides advice on the development and implementation of the DME Competitive Acquisition Program.

Bayer HealthCare, Diabetes Care, has underwritten the costs of this communication. The information expressed in this communication are the views of NCPA. Bayer is not responsible for the accuracy of the information expressed in this communication. Any questions related to DME Accreditation and/or Competitive Bidding for DMEPOS should be directed to the Centers for Medicare and Medicaid Services or NCPA.


	Sponsored by Fast Facts DMEPOS competitive bidding process will begin April 2007. CMS has announced the 10 MSAs where competitive bidding will be introduced. CMS has announced the product categories included in the first competitive bidding project. The Final Rule governing competitive bidding ensures that at least 30 percent of bid winners are small businesses. Suppliers must obtain accreditation to participate in competitive bidding. The ONLY exception to the rule is a pharmacy that maintains a Part B supplier billing number to submit Part B drug claims and administer vaccinations. Ten agencies have been approved to accredit suppliers of DMEPOS. Important Links: Medicare DME Home Page Medicare DME blog Medicare DMe-Alert Archive Evaluating DMEPOS Bids and Selecting Winners By William Popomaronis, R.Ph. As the result of its competitive bidding project, the Centers for Medicare & Medicaid Services (CMS) will establish a "single payment amount" for the items subject to competitive bidding based on the bids submitted. The single payment amount will become the new Medicare payment basis in the competitive bid areas. Suppliers participating in the competitive bidding process must bid on DMEPOS by product category. CMS will evaluate and take a weighted sum of bids on individual items in each product category. This is the composite bid. By example, if you want to bid on oxygen supplies and equipment, you must submit a bid on every CMS defined item in that product category. Next, CMS will establish the pivotal bid. The pivotal bid would be the highest composite bid based on bids submitted by suppliers for a product category. The pivotal bid would be the highest composite bid based on bids submitted by suppliers for a product category that includes a sufficient number of suppliers to meet the beneficiary demand for the items in that product category. Everyone at or below the pivotal bid is selected as a winner. The final rule provides for 30 percent of winning suppliers to be small businesses. If CMS determines after the initial evaluation of bids that there are not enough small suppliers with winning bids to meet the target goal of 30 percent in each product category, then contracts will be offered to small suppliers that submitted bids higher than, but close to the winning bids. The small suppliers will have the option to accept the single payment amounts based on the winning bids until the 30 percent goal is met or there are no more small suppliers.

	William Popomaronis, R.Ph., is vice president, long term and home health care services for the National Community Pharmacists Association (NCPA). He is also the only pharmacist member of Medicare’s Program Advisory and Oversight Committee (PAOC), which provides advice on the development and implementation of the DME Competitive Acquisition Program.

	Bayer HealthCare, Diabetes Care, has underwritten the costs of this communication. The information expressed in this communication are the views of NCPA. Bayer is not responsible for the accuracy of the information expressed in this communication. Any questions related to DME Accreditation and/or Competitive Bidding for DMEPOS should be directed to the Centers for Medicare and Medicaid Services or NCPA.