Tag: Round 2021

WASHINGTON – Medicare’s bid surety bond requirement did not have a negative impact on small supplier participation in Round 2021 of the competitive bidding, says the Government Accountability Office in a new report.  For the report, “Effect of New Bid Surety Bond Requirement on Small Supplier Participation in the Competitive Bidding Program,” the GAO reviewed CMS’ data on supplier bids and contracts, and interviewed two DME trade organizations, including AAHomecare,...

WASHINGTON – CMS on Aug. 5 published another batch of data on Round 2021, this time comparing information from that round to previous rounds of the program.  The agency provides data for each round for the following categories:  product categories bid  competitive bidding areas bid  competitions bid  bidders eligible to evaluate  bids eligible to evaluate  product categories bid and implemented  competitive bidding areas bid...

WASHINGTON – Newly released data from Round 2021 show that modifications to the competitive bidding program worked in a number of ways, but more are needed, say industry stakeholders.  The data reveal that 15,695 or 42% of bids submitted for the 13 major product categories dropped from Round 2021 were disqualified for reasons that included pricing and financial issues. Hundreds of bids were disqualified for invalid bid bonds.  “(Requiring) bid bonds reduced the amount...

WASHINGTON – CMS received 45,815 eligible bids for Round 2021 of the competitive bidding program, according to additional information it released today.  The total number of eligible bids did not include the 3,313 bids for non-invasive ventilators, which CMS dropped from the bidding program in April 2020 due to the COVID-19 public health emergency.  Total bidders who submitted at least one bid that was eligible to evaluate (i.e., at least one bid that was complete/certified...

FOOTHILL RANCH, Calif. – Össur has updated its proprietary Empower program to help physician practices and DMEPOS providers comply with new competitive bidding requirements for knee and back braces that went into effect Jan. 1.  Empower now has built-in prompts for new reimbursement coding and document capture requirements, and automatic mapping to designated contract providers based on a patient’s address.  “CMS’s new competitive bidding practice mandates...

In the past few months:  A global pandemic has severely stressed the supply of oxygen concentrators, revealing cracks in an HME industry that has been slowly chipped away at by Medicare’s competitive bidding program for 10 years.  CMS has decided not to move forward with the majority of Round 2021 of that program, because the agency didn’t “achieve expected savings,” and therefore – wait for it – the current reduced rates continue to apply.  The...

WASHINGTON – Industry stakeholders are still digging through the Round 2021 data that CMS furnished late on Jan. 15 and trying to figure out what’s behind the sometimes drastic variance in payment amounts.  For example, the amount for an oxygen concentrator was $72.36 in Akron, Ohio, but $189 in Chicago. The amount for CPAP devices was $38 in Oxnard, Calif., but $110.80 in Las Vegas. (Click here for more examples.) “It’s difficult to say...

WASHINGTON – CMS tonight released a “pivotal bid report” for Round 2021, in response to requests to share additional information on its latest round of the competitive bidding program. In the Las Vegas competitive bid area for example, the pivotal bid for CPAP devices, E601, was $110.80, a difference of 157.4% compared to the former CBA adjusted fee schedule amount. “CMS anticipates that this information will be helpful for stakeholders and other interested parties in...

ATLANTA - Wayne van Halem gets contacted “all the time” by companies that are having issues with audits. A common factor? Lead-generating companies, he says. These are companies that are new to the industry and those that are well established, he says. “They will convince people that they can make them a lot of money,” said van Halem, president of The van Halem Group. “They get told, ‘We’ll do all the work and the paperwork, and all you have to do is...

YARMOUTH, Maine – The notion that reimbursement rates have stabilized due to the pause in Round 2021 for most products is a “misconception,” say numerous respondents to a recent HME Newspoll.  CMS announced in October that it would not move forward with new single payment amounts for 13 product categories, instead continuing the current rates in bid areas.  “(Rates) have not stabilized and will continue to be an issue going...