Contract Supplier Resource Guide
Welcome to the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program! For your convenience we have created a single resource where you will find a comprehensive collection of documents to assist you and your staff with understanding your contractual obligations, payment policies, and to update your information.
Click on the Contract Supplier Obligations tab to review key performance requirements and links to the Supplier Standards and quality standards. On the Payment Policies tab, you can learn how the DMEPOS Competitive Bidding Program’s policies impact claims filing and payment. For contract maintenance information, go to the Update Form tab to learn how to update your information. You can also find helpful resources to assist you and your staff throughout the contract period on the Resources tab.
Contract Supplier Obligations
Contract Supplier Obligations
Contract suppliers are responsible for fulfilling all terms of their contracts, starting on the very first day of the contract period, for the duration of the contract period. This fact sheet consists of key contract terms you must comply with throughout the contract period.
DMEPOS Quality Standards
Medicare enrolled DMEPOS suppliers, including DMEPOS Competitive Bidding Program contract suppliers, must meet the DMEPOS quality standards.
Medicare DMEPOS Supplier Standards
This is an abbreviated version of the supplier standards every Medicare DMEPOS supplier must meet in order to obtain and retain their billing privileges. These standards in their entirety are listed in 42 C.F.R. 424.57 (c) and may be found on the National Supplier Clearinghouse (NSC) website.
Change of Ownership-Guidelines and Responsibilities
A DMEPOS supplier participating in the competitive bidding program that is negotiating a change of ownership (CHOW) must notify CMS 60 days before the anticipated date of the change. This fact sheet explains how to notify CMS, the process for transferring a contract, and the requirements to effectuate the transfer.
Common Ownership and Common Control
Suppliers are prohibited from competing against themselves when submitting bids in the DMEPOS Competitive Bidding Program. Therefore, suppliers that are commonly owned or commonly controlled must submit one bid for the same product category in the same CBA.
With the exception of skilled nursing facilities (SNFs) and nursing facilities (NFs) that become specialty suppliers, suppliers that are contract suppliers for the enteral nutrition product category must furnish services to beneficiaries throughout the competitive bidding area, regardless of whether a beneficiary lives in a private residence or institutional setting.
Exemptions from the Requirement to Be a Contract Supplier for Competitively Bid Items and Services
Non-contract suppliers that furnish competitively bid items in a CBA are not eligible for Medicare Part B payment for the competitively bid items for that CBA unless one or more exceptions apply.
Grandfathering for Oxygen and Oxygen Equipment
Suppliers that are not awarded a competitive bidding contract for furnishing oxygen and oxygen equipment in a CBA can decide to be grandfathered suppliers for beneficiaries to whom they are furnishing these items at the time the competitive bidding program is implemented.
Grandfathering for Rented DME
Suppliers that are not awarded a competitive bidding contract for furnishing rented DME in a CBA can decide to be grandfathered suppliers for beneficiaries to whom they are furnishing these items at the time the competitive bidding program is implemented.
Hospitals That Are Not Contract Suppliers
This fact sheet discusses an exception, which allows hospitals to furnish competitively bid walkers in a competitive bidding area to their own patients without being a contract supplier.
National Mail-Order Recompete Competition for Diabetic Supplies
Federal regulations include an “anti-switching” provision as a term of the contract for suppliers under the national mail-order recompete for diabetic supplies. This regulation prohibits contract suppliers from influencing or incentivizing beneficiaries to switch their current glucose monitor and testing supplies brand to another brand.
Physicians and Other Treating Practitioners Who are Enrolled as Medicare DMEPOS Suppliers
Physicians and other treating practitioners who are enrolled as Medicare DMEPOS suppliers may furnish certain competitively bid items in a CBA to their own patients without submitting a bid and being selected as a contract supplier, if specific requirements are met.
Prescription for Specific Brand or Mode of Delivery to Avoid an Adverse Medical Outcome
The Medicare DMEPOS Competitive Bidding Program includes a special beneficiary safeguard to ensure that beneficiaries have access to specific brands or modes of delivery of competitively bid items when needed to avoid an adverse medical outcome.
Repairs and Replacements
This fact sheet contains important information about repairs and replacements of beneficiary-owned equipment under the DMEPOS Competitive Bidding Program.
Skilled Nursing Facilities (SNFs) and Nursing Facilities (NFs)
Skilled nursing facilities (SNFs) and nursing facilities (NFs) are subject to the Medicare DMEPOS Competitive Bidding Program to the extent that competitively bid items and services are furnished to their own residents under Medicare Part B.
Subcontracting of DMEPOS Services
The primary supplier is responsible for the overall service of furnishing the item and coordinating the care for the beneficiary in compliance with the physician’s order and Medicare rules and guidelines, but the primary supplier may subcontract certain services.
Supplier Marketing Guidelines
All of the existing rules and regulations regarding marketing DMEPOS to beneficiaries under the fee-for-service program also apply to DMEPOS contract suppliers under competitive bidding.
Tips for Serving Qualified Medicare Beneficiaries
When serving dually eligible beneficiaries in your area, it is important to understand the special protections for the 7 million who are “Qualified Medicare Beneficiaries.”
This fact sheet contains guidance about a supplier’s responsibilities when a beneficiary transitions from a current supplier to a new supplier.
DMEPOS suppliers that provide items to Medicare beneficiaries who reside in or travel to competitive bidding areas must follow specific guidelines. This fact sheet includes information on how to determine whether a beneficiary is in a traveling status, how to properly bill Medicare for the item, and how Medicare will determine the payment amount.
Go to Connexion to access the Contract Supplier Change of Location/Information Update Form.
- Add a location(s) to a product category(s) on your contract
- Remove a location(s) from a product category(s) on your contract
- Add a product(s) in a product category on your contract for a location(s) on your contract
- Remove a product(s) in a product category on your contract for a location(s) on your contract
- Add or update toll-free number for the Supplier Directory on the Medicare website
Instructions for contract suppliers to change, remove, or add a role in Connexion, and to update the competitive bidding contract record accordingly, and to update an e-mail address can be found in the guide How to Update Information in CMS’ Enterprise Identity Management (EIDM) System.
We want you to get what you need as soon as possible. Here are resources to help.
Do you want to…
- Review and print your contract? Access Connexion.
- Obtain the most current information about the competitive bidding program? Go to the CBIC website at www.dmecompetitivebid.com.
- Find specific information on the website, but you cannot locate it? Click on located at the bottom right-hand side of the website, for general questions and website navigation assistance.
- Ask policy questions or obtain help with completing contract maintenance forms? Call the Competitive Bidding Implementation Contractor (CBIC) customer service center toll-free at 877-577-5331. The customer service center is available between 9 a.m. and 5:30 p.m. prevailing Eastern Time, Monday through Friday.
- Have a policy rule clarified, request assistance with servicing beneficiaries, or need clarification on other competitive bidding questions? E-mail CBIC.Admin.
- Obtain guidelines on specific policies, get assistance on a Medicare beneficiary issue, or request participation at a workshop or meeting? Contact your regional Competitive Bidding Liaison.
- Receive e-mail updates about the DMEPOS Competitive Bidding Program? Register for our listservs.
- Ask enrollment questions? Contact the National Supplier Clearinghouse (NSC) at 866-238-9652.
- Find out the status of a claim or ask claim questions? Contact the DME MAC for the area where the beneficiary resides.