The Centers for Medicare and Medicaid Services (CMS) will be implementing a new program January 1, 2011 that will change how Medicare beneficiaries and their referral sources can obtain medical equipment. Presently Medicare beneficiaries and referral sources are allowed to choose a medical equipment supplier of their choice. The new program called “competitive bidding” will reduce the choices for beneficiaries and referral sources.

CMS has contracted with a limited number of medical equipment suppliers in 9 competitive bid areas (CBA’s) across the United States. Medicare Beneficiaries living in those 9 CBA’s will be required to use a medical equipment company from the approved list of contracted suppliers to receive certain pieces of Medical Equipment. The list of the products and the nine areas affected are below:

The Products included in the competitive bidding program

·         Oxygen Equipment & Supplies

·         Standard Power Wheelchairs, Scooters, and Related Accessories

·         Complex Rehabilitative Power Wheelchairs and Related Accessories-(Certain products)

·         Mail-Order Replacement Diabetic Supplies- Mail Order Only

·         Enteral Nutrients, Equipment and Supplies

·         CPAP, RADS, and Related Supplies and Accessories

·         Hospital Beds and Related Accessories

·         Walkers and Related Accessories

·         Support Surfaces (Group 2 mattresses and overlays) in Miami Only

The Nine Competitive Bid Areas starting January 1, 2011

·         Cincinnati-Middletown (Ohio, Kentucky and Indiana)

·         Cleveland-Elyria-Mentor (Ohio)

·         Charlotte-Gastonia-Concord (North Carolina and South Carolina)

·         Dallas-Fort Worth-Arlington (Texas)

·         Kansas City (Missouri and Kansas)

·         Miami-Fort Lauderdale-Pompano Beach (Florida)

·         Orlando (Florida)

·         Pittsburgh (Pennsylvania)

·         Riverside-San Bernardino-Ontario (California)

The complete county listing for all 9 CBA’s can be found at www.medicaresuppliersnetwork.com.

How will this affect Referral sources and Medicare beneficiaries?

This will affect you (the referral source) and your Medicare beneficiary in numerous ways. 

1.       If a patient needs one of the products listed above, and resides in one of the CBA’s they are required to get the products from a Medicare contracted supplier for that area.

2.       If a patient currently uses one of the products above, and the patient resides in one of the CBA’s listed above, they may be required to change providers, to a Medicare contracted supplier.  (Some exceptions are allowed, see www.medicaresuppliersnetwork.com for the list of exceptions)

3.       If a patient resides in one of the CBA’s listed above, they may only continue using their preferred medical equipment supplier if the supplier won the product category for that CBA. 

4.       You may be required to use multiple suppliers for different products to fulfill your patient’s needs.

The list of approved contracted medical equipment suppliers will not be released by CMS until September 2010. The list will include the name and contact information for the medical equipment companies that are contracted for each competitive bid area (CBA) and each product category.

We realize that this sounds confusing and you may have a lot of questions about the program and how it will affect you or your patients.  A website has been created to help educate both the Medicare beneficiary and all referral sources. This website is educational only. www.medicaresuppliersnetwork.com will answer any questions you may have. We will also be providing additional information as soon as it is released by CMS. You may also email us at info@medicaresuppliersnetwork.com to answer any questions you may have.

Note- The competitive bidding program only applies to Medicare patients residing in the 9 areas that are in need or are using the products listed above and begins January 1, 2011. If your patient resides outside of the 9 areas listed above or they are not on Medicare then the process for obtaining medical equipment remains the same as today.