Your Guide to Medicare's Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program PDF Download
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Author: U. S. Department Human Services Publisher: CreateSpace ISBN: 9781493511594 Category : Languages : en Pages : 32
Book Description
Medicare's Competitive Bidding Program for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) changes the amount Medicare pays for certain DMEPOS items and makes changes to which suppliers Medicare will pay to supply these items to you. The first phase of the program is already in effect in 9 areas of the country. Starting July 2013, Medicare is scheduled to expand the competitive bidding program to more areas. The program replaces the outdated, inflated fee-schedule prices Medicare is currently paying with lower, more accurate prices. Under this program, suppliers submit bids to provide certain medical equipment and supplies at a lower price than what Medicare pays for these items now. Medicare uses these bids to set the amount it will pay for those equipment and supplies under the competitive bidding program. Qualified, accredited suppliers with winning bids are chosen as Medicare contract suppliers. The program: Helps you and Medicare save money; Ensures that you have access to quality medical equipment, supplies, and services from suppliers you can trust; Helps limit fraud and abuse in the Medicare Program. If you have Original Medicare, live in one of the competitive bidding areas, and use equipment or supplies included under the program (or get the items while visiting a competitive bidding area), you generally must use Medicare contract suppliers if you want Medicare to help pay for the item. If you live in one of the areas where the program is expanding and you're renting oxygen or certain other durable medical equipment (DME) at the time the program starts, you'll be able to continue renting these items from your current supplier if that supplier becomes a contract supplier or decides to participate in the program as a "grandfathered" supplier. If you live in (or get these items while visiting) these areas and don't use a Medicare contract or a grandfathered supplier, Medicare won't pay for the item, and you may have to pay full price. It's important to know if you're affected by this program to make sure Medicare will help pay for your item and to avoid any disruption of service. The competitive bidding program applies to Original Medicare only. If you're enrolled in a Medicare Advantage Plan (like an HMO or PPO), your plan will notify you if your supplier is changing. If you're not sure, contact your plan. Also available in Spanish.
Author: U. S. Department Human Services Publisher: CreateSpace ISBN: 9781493511594 Category : Languages : en Pages : 32
Book Description
Medicare's Competitive Bidding Program for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) changes the amount Medicare pays for certain DMEPOS items and makes changes to which suppliers Medicare will pay to supply these items to you. The first phase of the program is already in effect in 9 areas of the country. Starting July 2013, Medicare is scheduled to expand the competitive bidding program to more areas. The program replaces the outdated, inflated fee-schedule prices Medicare is currently paying with lower, more accurate prices. Under this program, suppliers submit bids to provide certain medical equipment and supplies at a lower price than what Medicare pays for these items now. Medicare uses these bids to set the amount it will pay for those equipment and supplies under the competitive bidding program. Qualified, accredited suppliers with winning bids are chosen as Medicare contract suppliers. The program: Helps you and Medicare save money; Ensures that you have access to quality medical equipment, supplies, and services from suppliers you can trust; Helps limit fraud and abuse in the Medicare Program. If you have Original Medicare, live in one of the competitive bidding areas, and use equipment or supplies included under the program (or get the items while visiting a competitive bidding area), you generally must use Medicare contract suppliers if you want Medicare to help pay for the item. If you live in one of the areas where the program is expanding and you're renting oxygen or certain other durable medical equipment (DME) at the time the program starts, you'll be able to continue renting these items from your current supplier if that supplier becomes a contract supplier or decides to participate in the program as a "grandfathered" supplier. If you live in (or get these items while visiting) these areas and don't use a Medicare contract or a grandfathered supplier, Medicare won't pay for the item, and you may have to pay full price. It's important to know if you're affected by this program to make sure Medicare will help pay for your item and to avoid any disruption of service. The competitive bidding program applies to Original Medicare only. If you're enrolled in a Medicare Advantage Plan (like an HMO or PPO), your plan will notify you if your supplier is changing. If you're not sure, contact your plan. Also available in Spanish.
Author: Centers for Centers for Medicare & Medicaid Services Publisher: ISBN: 9781534703117 Category : Languages : en Pages : 32
Book Description
This comprehensive booklet describes Medicare's Durable Medical Equipment and Supplies Competitive Bidding Program. This is a low-cost edition of a government document available online.
Author: Kathleen M. King Publisher: DIANE Publishing ISBN: 1437988490 Category : Medical Languages : en Pages : 29
Book Description
In 2009, Medicare spent approx. $8.1 billion on durable medical equipment (DME), prosthetics, orthotics, and related supplies for 10.6 million beneficiaries. DME includes items such as wheelchairs, hospital beds, and walkers. Medicare beneficiaries typically obtain DME items from suppliers, who submit claims for payment for these items to Medicare on behalf of beneficiaries. The Centers for Medicare & Medicaid Services (CMS), an agency within the Dept. of Health and Human Services (HHS), has responsibility for administering the Medicare program. Medicare and its beneficiaries -- through their out-of-pocket costs -- have sometimes paid higher than market rates for various medical equipment and supplies. To achieve Medicare savings for DME and to address DME fraud concerns, Congress required CMS to phase in a competitive bidding program (CBP) for DME suppliers in selected competitive bidding areas (CBA). In CBP, suppliers submit bid prices in the amounts they are willing to accept as payment to provide DME items to Medicare beneficiaries. CMS then enters into contracts with select DME suppliers to provide DME items at the prices determined by CBP. In contrast to CBP's supplier-level approach, some health care purchasers use a manufacturer-level approach to buy DME items directly from DME manufacturers to obtain savings by leveraging their purchasing power. CMS has not been required to develop a manufacturer-level approach. This report provides information on health care purchasers that currently use a manufacturer-level approach and on issues that would need to be addressed if CMS implemented such an approach. It describes (1) efforts used by some non- Medicare purchasers to reduce DME spending by contracting with DME manufacturers or using purchasing intermediaries, and (2) issues that CMS might face if required to implement a DME manufacturer-level approach with broad authority to do so. Figures and tables. This is a print on demand report.
Author: Kathleen M. King Publisher: DIANE Publishing ISBN: 1437926851 Category : Health & Fitness Languages : en Pages : 65
Book Description
In 2007, Medicare spent $8.3 billion for durable medical equipment (DME) and related supplies. To reduce spending, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) required that the Centers for Medicare and Medicaid Services (CMS) phase in a competitive bidding program (CBP) for DME and other items. DME suppliers began bidding in round 1 of the CBP in May 2007. After contracts were awarded, the Medicare Improvements for Patients and Providers Act of 2008 was enacted in July 2008. This report examined: (1) the results of CBP round 1; (2) the major challenges CMS had in conducting CBP round 1; and (3) the steps CMS has taken to improve future CBP rounds. Charts and tables.
Author: United States. Government Accountability Office Publisher: ISBN: Category : Medical instruments and apparatus industry Languages : en Pages : 42
Author: Kathleen M. King Publisher: DIANE Publishing ISBN: 1437905706 Category : Health & Fitness Languages : en Pages : 16
Book Description
Medicare has paid higher than market rates for medical equip. and supplies provided to beneficiaries under Medicare Part B. Medicare has used fee schedules based on historical charges to set payment amounts. But this approach lacks flexibility to keep pace with market changes and increases costs to the fed. gov¿t. CMS is required to test competitive bidding as a new way to set payments. CMS did this through a demonstration in two locations in which suppliers could compete on the basis of price and other factors for the right to provide their products. This testimony describes the effects that competitive bidding could have on Medicare program payments and suppliers and the need for adequate oversight to ensure quality and access. Illustrations.
Author: Kathleen M. King Publisher: ISBN: 9781457866142 Category : Languages : en Pages : 57
Book Description
To achieve Medicare savings for durable medical equipment (DME), the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 required that the Centers for Medicare & Medicaid Services (CMS) implement the competitive bidding program (CBP) for certain DME. The first completed CBP round -- the round 1 rebid -- operated in nine competitive bidding areas. CMS reported total savings of more than $580 million at the end of the round 1 rebid's 3-year term due to lower payments and decreased utilization. This report examines (1) bidding process results for the round 1 recompete, round 2, and national mail-order program, and how they compare to the concluded round 1 rebid results; and (2) how single payment amounts (SPAs) for selected Healthcare Common Procedure Coding System (HCPCS) codes common to the round 1 rebid, round 1 recompete, round 2, and national mail-order program compare. Tables and figures. This is a print on demand report.
Author: American Dental Association Publisher: American Dental Association ISBN: 1941807712 Category : Medical Languages : en Pages : 10
Book Description
Section 1557 is the nondiscrimination provision of the Affordable Care Act (ACA). This brief guide explains Section 1557 in more detail and what your practice needs to do to meet the requirements of this federal law. Includes sample notices of nondiscrimination, as well as taglines translated for the top 15 languages by state.
Author: U. S. Department Human Services
Author: U. S. Department Human Services
Author: Centers for Medicare & Medicaid Services (U.S.)
Author: Centers for Centers for Medicare & Medicaid Services
Author: Kathleen M. King
Author: 
Author: Kathleen M. King
Author: United States. Government Accountability Office
Author: Kathleen M. King
Author: Kathleen M. King
Author: American Dental Association