| Antitrust Guidance (PDF, PDF - 93 KB)|
The antitrust laws protect competition and prohibit collusion. Price fixing, bid rigging, and other forms of collusion, including agreements to allocate customers or divide markets, are illegal...
|Billing Procedures for Upgrades|
Medicare payment for upgrades will be based upon the payment amount applicable to the item in the area in which the beneficiary resides...
| Bona Fide Bids (PDF, PDF - 133 KB)|
The Competitive Bidding Program regulations require that each bidder must submit a bona fide bid that complies with all the terms and conditions specified in the request for bids (RFB)...
| Capacity and Expansion Plan (PDF, PDF - 201 KB)|
This fact sheet describes how CMS conducts its review of supplier capacity and expansion plans during the bid evaluation process...
| Change of Ownership (PDF, PDF-161 KB)|
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...
| Common Ownership or Control (PDF, PDF - 146 KB)|
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...
| Competitive Bidding Areas (CBAs) (PDF, 125 KB)|
Fact sheet about the nine CBAs included in the Round 1 Rebid...
| Contract Supplier Obligations (PDF, PDF - 290 KB)|
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. Here are key contract terms with which contract suppliers must comply throughout the contract period...
| Covered Document Review Date (PDF, PDF - 146 KB)|
Suppliers that submit their financial documents by a deadline called the Covered Document Review Date (CDRD) will have their documents checked to determine if any individual financial documents are missing, will be notified of what is missing, and will have an opportunity to submit the missing documents...
| Eligibility Requirements (PDF, 157 KB)|
A supplier must meet certain eligibility requirements before it can submit a bid and be awarded a contract under the Competitive Bidding Program...
| Enteral Nutrition (PDF, 153 KB)|
With the exception of SNFs and NFs that become specialty suppliers, suppliers that are contract suppliers for the enteral nutrition product category must furnish services to beneficiaries throughout CBA, regardless of whether a beneficiary lives in a private residence or institutional setting...
| Exemptions (PDF, 180 KB)|
For the Round 1 Rebid, 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 of the exceptions listed applies...
| Grandfathering for Rented DME (PDF, PDF - 599 KB)|
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...
| Grandfathering for Rented Oxygen (PDF, PDF - 590 KB)|
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 Requirements for Non-Contract Suppliers Fact Sheet|
Suppliers that are not awarded a competitive bidding contract for furnishing rented DME and/or 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.
|Hospitals That Are Not Contract Suppliers|
For the first phase of competitive bidding, one exception allows hospitals to furnish competitively bid walkers in a CBA to their own patients without submitting a bid and being selected as a contract supplier.
| Licensure for Bidding Suppliers (PDF, PDF - 140 KB)|
Suppliers submitting a bid for a product category in a CBA must meet all DMEPOS state licensure requirements and other applicable state licensure requirements, if any, for that product category for every state in that CBA...
| Licensure for Contract Suppliers (PDF, PDF - 111 KB)|
As a contract supplier for the Medicare DMEPOS Competitive Bidding Program, you must comply with all applicable state and local laws. This includes maintaining compliance with all applicable state and local licensing requirements pertaining to functions under your contract throughout the duration of the contract period...
| Mail-Order Diabetic Supplies (PDF, PDF - 107 KB)|
The term “mail-order” refers to items ordered remotely and delivered to a beneficiary’s residence by common carriers and does not include items obtained by beneficiaries from local supplier storefronts...
|Non-Contract Supplier Fact Sheet|
Under the Medicare DMEPOS Competitive Bidding Program, beneficiaries with Original Medicare who obtain competitive bidding items in designated CBAs are required to obtain these items from a contract supplier, unless an exception applies. This fact sheet contains important information for suppliers that do not become contract suppliers...
|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 (PDF, PDF - 180 KB)|
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.
| Round 1 Rebid Items and Services (PDF, PDF - 101 KB)|
The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) designated the items that are included in the Round 1 Rebid. Specifically, MIPPA requires that we compete the same items and services in the Round 1 Rebid as were previously bid in Round 1 with certain limited exceptions...
| Specialty Suppliers (SNF or NF) (PDF, 151 KB)|
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 residents under Medicare Part B...