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Grandfathering Information

If a beneficiary who resides in a competitive bidding area (CBA) changes from a Medicare Advantage (MA) Plan, either voluntarily or involuntarily, to Medicare fee-for-service (original Medicare), can he/she remain with his/her current managed care supplier even if the supplier is not a contract supplier for the specific competitively bid item the beneficiary receives from the supplier? Will Medicare continue to pay the supplier for the items and services?


07/30/2014
Are competitively bid capped rental items subject to the payment reduction after the 3rd month rental?


05/16/2013
Can a non-contract supplier furnish competitively bid items to beneficiaries maintaining a permanent residence within a CBA?Open in New Window

05/16/2013
Can a supplier choose to grandfather certain beneficiaries and not others?


05/16/2013
If a beneficiary has been renting a competitively bid durable medical equipment (DME) item from a supplier that does not become a contract supplier and chooses to switch to a contract supplier at the start of a competitive bidding program, what month should the new contract supplier start billing? When can the non-contract supplier pick up its equipment?


05/16/2013
If a beneficiary who is receiving capped rental durable medical equipment (DME) or oxygen prior to the start of the competitive bidding program moves from a non-competitive bidding area to a competitive bidding area (CBA), is a contract supplier eligible to start a new capped rental period or entitled to receive additional payments for oxygen?


05/16/2013
What will contract suppliers be paid when they furnish oxygen and oxygen equipment or capped rental durable medical equipment (DME) to a beneficiary who transitions to them from a non-contract supplier in the middle of the 36-month or 13-month rental payment period?


05/16/2013


last updated on 07/30/2014

 


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