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News & Press: Advocacy and Policy

Round 2 in Medicare's Competitive Bidding Program (CBP)

Tuesday, August 20, 2013   (0 Comments)
Posted by: Becky Dryden
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Starting July 1, Medicare patients who live, or are being treated in, a Medicare competitive bidding area may have to locate a new supplier for negative pressure wound therapy (NPWT) based on newly awarded Medicare contracts. July marked the start of Round 2 in Medicare's Competitive Bidding Program (CBP) which now includes NPWT products in the program. As of July 1, 2013, only winners of competitive bids will be able to bill Medicare for NPWT-related codes, including E2402 (NPWT pumps), A6550 (NPWT supplies including dressings), and A700 (NPWT canisters). Round 2 of competitive bidding will impact 91 cities across the country.

The competitive bidding program for durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) fundamentally changes Medicare's approach to reimbursing DMEPOS suppliers under Medicare Part B from the current use of fee schedules to a system that sets reimbursement rates through a bidding process between the Centers for Medicare and Medicaid Services (CMS) and designated suppliers. The winning bids will be used to establish a single Medicare payment for each item.

Under the program, a competition among suppliers who operate in a particular competitive bidding area (CBA) is conducted. Suppliers are required to submit a bid for selected products (now including NPWT). Not all products or items are subject to competitive bidding. Bids are submitted electronically through a web-based application process and required documents are mailed. Bids are evaluated based on the supplier's eligibility, its financial stability and the bid price. Contracts are awarded to the Medicare suppliers who offer the best price and meet applicable quality and financial standards. Contract suppliers must agree to accept assignment on all claims for bid items and will be paid the bid price amount.

Skeptics of the CBP have concerns that it will result in poorer quality of care for patients as they will no longer have a choice of suppliers from whom to receive their products from. The current bidding program could restrict access to, and choice of, DME items and services by forcing consumers to use certain durable medical equipment providers whether they furnish the products and services that provide the most benefit to consumers or not. With fewer providers allowed to provide products and services, normal expedient deliveries of items and services are being eliminated and therefore Medicare costs are increasing because patients are being hospitalized for longer periods and may require more frequent physician visits.

If you or your patients have been negatively impacted by the CBP please contact the WOCN Society (wocn_info@wocn.org) so we can catalogue your concerns. Efforts are underway in Congress to delay or reshape the program and the WOCN Society continues to follow this issue closely, so please feel free to contact us with questions and/or concerns.

More Questions?

  • You may find detailed information about the program on the Centers for Medicare and Medicaid Services (CMS) website here.
  • For information on the new NPWT reimbursement amounts, please click here.
  • For information on the contracted supplier list by Competitive Bidding area (using CMS' searchable database by zip code), please click here.
  • To see if your zip code is impacted by this program, please click here.


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