A Medicare “competitive bidding” program touted by the federal government as a powerful cost-saving initiative will now be expanding across the country this summer. Round 2 of this program will impact Durable Medical Equipment (DME) suppliers’ ability to bill Medicare for various medical devices, including negative pressure wound therapy (NPWT) equipment and supplies.
The program required DMEs to bid for contracts which would allow them to bill Medicare for equipment used by patients in certain Competitive Bid Areas (CBA). The Center for Medicare and Medicaid Services says, “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.”
Round 2 of competitive bidding related to NPWT equipment and supplies has had strong implications for DMEs who provide these products. As of July 1, 2013, only competitive bid winners will be able to bid Medicare for NPWT-related codes, including E2402 (NPWT pumps), A6550 (NPWT supplies including dressings), and A700 (NPWT canisters). This round of competitive bidding will impact 91 cities across the country and a total of 100 CBAs, as Los Angeles, New York, and Chicago have multiple CBAs.
If you are a DME who has won a competitive bid and would like more information about our extriCARE™ NPWT System, please contact us.
According to the Pittsburgh Tribune-Review:
Until now, Medicare prices for durable equipment and related supplies have been set according to a fee schedule that was established in the 1980s and has been updated for inflation. But officials at the Department of Health and Human Services say the older system has proved vulnerable to fraud and price inflation. About 20 million people who receive Medicare fee-for-service benefits live in the 100 metropolitan areas where the program is scheduled to operate, according to officials with the Department of Health and Human Services. Only a fraction of those beneficiaries need durable equipment supplies. But the initiative is expected to save $27 billion for Medicare Part B, which covers physician and out-patient services, and $17 billion for beneficiaries, between 2013 and 2022.