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Grandfathering Information

Non-contract suppliers that are renting competitively bid durable medical equipment (DME)* or oxygen and oxygen equipment at the time a round of competition begins for the DMEPOS Competitive Bidding Program may choose to become grandfathered suppliers for these items. A non-contract supplier that chooses to become a grandfathered supplier for any product category is required to grandfather all items within that product category to all Medicare beneficiaries who are renting the DME or oxygen and oxygen equipment at the time contracts for a given round of bidding become effective. The Round 1 2017 contracts become effective on January 1, 2017.

Notification Requirements
Non-contract suppliers must provide written notification of their decision whether to become a grandfathered supplier to all of their Medicare beneficiaries who reside in a competitive bidding area (CBA) and are currently renting competitively bid DME or oxygen and oxygen equipment at least 30 business days prior to program implementation. The notification must inform the beneficiaries about their decision whether to grandfather and explain the grandfathering process and the beneficiaries' options.

*Rented DME items include standard nebulizers, standard manual wheelchairs, group 1 support surfaces, group 2 support surfaces, transcutaneous electrical nerve stimulation devices (TENS), commode chairs, patient lifts, seat lifts, negative pressure wound therapy (NPWT) pumps, continuous positive airway pressure devices (CPAPs), respiratory assist devices (RADs), walkers, standard power wheelchairs, scooters, and hospital beds.

In accordance with the final rule published on December 2, 2013 (78 FR 72224), the following items are being reclassified to the capped rental payment class effective July 1, 2016.

E0140   E0149   E0985   E1020   E1028  E2228  E2368
E2369   E2370   E2375   K0015   E0070  E0955  E0197

Items in the enteral nutrients, equipment and supplies product category cannot be grandfathered.

Grandfathering Requirements for Non-Contract Suppliers Fact SheetOpen in New Window
Non-contract suppliers that furnish competitively bid rented DME or oxygen and oxygen equipment to beneficiaries in CBAs must: (1) decide if they will elect to become grandfathered suppliers, (2) notify beneficiaries of their grandfathering decisions, and (3) fulfill other requirements as described in this fact sheet...

last updated on 11/30/2017


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