Competitive bidding: CMS to combine all future bids into one

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Wednesday, February 1, 2017

WASHINGTON – CMS today announced it will consolidate all rounds of the competitive bidding program into a single competition, Round 2019.

Round 2019 will include 141 competitive bidding areas (CBAs) and have a total of 11 product categories. Contracts will be effective Jan. 1, 2019 through Dec. 31, 2021.

The current Round 1 2017, Round 2 re-compete, and national mail-order program for diabetes end on Dec. 31, 2018.

CMS also announced several changes to the program for Round 2019. Insulin pumps and supplies will be added as a product category. CMS is also adding 10 new CBAs to the program for the CPAP devices and related accessories product category only.  

The other product categories are: enteral nutrients, equipment and supplies; general HME and related supplies and accessories; nebulizers, negative pressure wound therapy; respiratory equipment; standard mobility equipment and TENS devices.

In five of these 10 new CBAs, payment for the CPAP device, related accessories, and services will be made on a bundled, non-capped monthly rental basis, while payment in the other five CBAs will be made on a capped monthly rental basis like all other existing CBAs.

CMS is also including a lead item bidding methodology for certain items in Round 2019 in which suppliers will bid for a lead item within a grouping of similar equipment that takes into account the costs of furnishing all of the equipment in the grouping. The single payment amount for the other items within the grouping will be based on their relative differences in fees when compared to the lead item.

In the most recent round of bidding, Round 1 2017, providers saw an overall reduction in reimbursement of 5.2% from the Round 1 re-compete. The Round 1 re-compete saw an overall reduction in reimbursement of 37%.

In the most recent round of the national mail-order category for diabetes supplies, providers saw the reimbursement for a box of test strips decrease by about 21%—from $10.41 to $8.32—compared to the previous round.