CMS selects nearly 800 DMEPOS suppliers in competitive bidding program

In an effort to save money, the Centers for Medicare & Medicaid Services is expanding its competitive bidding program for durable medical equipment, prosthetics and other supplies (DMEPOS).

The agency recently announced that it selected about 800 suppliers to participate in the program, which is being expanded to 91 markets in July.  Click here for a list of suppliers.

The program, which is designed to save money, changes the amount that Medicare pays for certain durable medical equipment, prosthetics, orthotics, and supplies.

In addition, CMS announced that another 18 companies from around the country have accepted contracts to provide mail-order diabetic testing supplies at competitively bid prices nationwide.

All contract suppliers must comply with Medicare enrollment rules, be accredited, meet applicable licensing requirements, and meet financial standards.  Ninety percent of contract suppliers are already established in the competitive bidding area, the product category, or both.  Small suppliers, those with gross revenues of $3.5 million or less as defined for the DMEPOS competitive bidding program, make up about 63 percent of the Round 2 contract suppliers, according to a CMS press release.

Based on bids submitted by these suppliers, beneficiaries and Medicare will see prices, on average, 45 percent lower than Medicare now pays for the same items included in the Round 2 areas and 72 percent lower on mail-order diabetic testing supplies nationwide.

Higher Use of Advanced Imaging Services by Providers Who Self-Refer Costing Medicare Millions

Dec. 14, 2012 – The Centers for Medicare & Medicaid Services (CMS) is considering Government Accounting Office  (GAO) recommendations to review self-referred advanced imaging services by self-referring providers to assure the appropriateness of the referrals.

The GAO reAn example of advanced medical imagingcently completed a study and determined that the number of self-referred advanced imaging services, such as magnetic resonance imaging (MRI) and computed tomography (CT) services, grew at a substantially greater rate than non-self-referred services.

The study also showed that referrals of MRI and CT services substantially increased after physicians began to self-refer after either acquiring imaging equipment or joining a practice that already self-refers.  The GAO stated that their findings suggest that the increase in the average number of referrals by physicians who became self-refers was not due to a general increase in the use of imaging services among all providers but that financial incentives for self-referring were a major factor.

The GAO stated that “to the extent that these additional referrals were unnecessary, they pose unacceptable risks for beneficiaries, particularly in the case of CT services, which involve the use of ionizing radiation that has been linked to an increased risk of developing cancer.” Unnecessary referrals also place an unjustifiable burden on the Medicare program.

Click here to read the entire GAO report and HHS’ response.



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