CMS resets payment amounts for Round 2

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Tuesday, March 15, 2016

BALTIMORE – CMS today announced the new single payment amounts for the Round 2 re-compete of competitive bidding.

CMS will now begin the contracting process. The agency will offer 12,181 contracts to 637 bidders. Of these offers, 93% are to bidders who currently furnish items in the area or within the product category. CMS will offer nine contracts for the national mail-order program.

CMS estimates that the first two years of Round 2 and the national mail-order program (July 1, 2013 and June 30, 2015) have saved approximately $3.6 billion.

Reimbursement rates for certain HME have been, on average, 45% lower as part of the previous Round 2. Medicare beneficiaries saved, on average, 72% of diabetic testing supplies as part of the previous national mail-order program.

CMS’s next steps:

•    It will now begin the contracting process.

•    In the spring of 2016, it plans to announce the contract suppliers.

•    On July 1, 2016, it plans to go live with the payment amounts and contract suppliers.

For single payment amounts:

Midwest Region

Northeast Region

South Region

South Region

West Region

For CMS's fact sheet:

The Round 2 re-compete applies to 90 metropolitan statistical areas for seven product categories:

·      Enteral nutrients, equipment and supplies

·      General home equipment and related supplies and accessories, including hospitals beds, Group 1 and 2 support surfaces, commode chairs, and patient and seat lifts

·      Nebulizers and related supplies

·      Negative pressure wound therapy pumps and related supplies

·      Respiratory equipment and related supplies and accessories, including oxygen, oxygen equipment and supplies; CPAP devices and RADs and related supplies and accessories

·      Standard mobility equipment and related accessories, including walkers, standard power and manual wheelchairs, scooters and related accessories

·      Transcutaneous electrical nerve stimulation devices and supplies

 

CMS launched Round 2 on July 1, 2013, in 91 cities for eight product categories:

•    Oxygen supplies and equipment;

•    Standard manual and power wheelchairs and scooters and related accessories;

•    Enteral nutrients, equipment and supplies;

•    CPAP devices, respiratory assist devices and related supplies and accessories;

•    Hospital beds and related accessories;

•    Walkers and related accessories;

•    Support surfaces; and

•    Negative pressure wound therapy pumps and related supplies and accessories