Information for Hospitals about the Medicare Competitive Bidding Program
For hospitals the Medicare competitive bidding program can present several challenges. This article outlines the most common scenarios that may affect patients when being just discharged.
Speeding up the discharge process
You will notice a green checkmark next to some search results. This green checkmark signifies that the provider is contracted for all of the product categories you selected. These results appear near the top of the page. Our system is organized in this matter to help you find companies that can provide the items you require with one phone call.
However, you may not always find a single company with all of the contracts you selected. The Medicare competitive bidding program is divided into eight product categories (nine in Miami). Each contracted medical equipment provider they have one or more of these contracts. Your patient may require products from one or several product categories. This means that you may need to contact more than one supplier in order to fulfill all of the physician's orders.
Patients requiring new equipment
For patients leaving your facility with orders for new medical equipment, which they have not previously had, you may experience some changes. First, if the product is included in one of the nine contract categories and the patient resides in a competitive bidding area (CBA) you will need to direct that order to a contracted supplier. Use the search function here and getDME.com to find a contracted supplier.
Only suppliers who are contracted for enteral nutrition products under the Medicare competitive bidding program may supply these items to patients. There are no grandfathering provisions for this product category.
Therefore, if the patient is leaving your facility and requires enteral nutrition products ( these include: enteral formula, pumps, IV poles, syringes, bags, and pump sets) you will need to make arrangements with the contracted supplier to deliver these products.
Side note: grandfathering is a process which allows non-contracted equipment suppliers to provide some rental items to patients who were on their service prior to January 1, 2011. Grandfathering is not permitted for enteral nutrition.
Patients with existing equipment
If your patient already has the medical equipment that was prescribed in your facility they may be able to keep their existing equipment. If the patient is satisfied with their existing supplier know action is generally needed. However, the patient does have the option to change to a contracted supplier at any time after the Medicare competitive bidding program begins. Doing so may entitle the patient to receive new equipment.
Enteral nutrition formulas are an exception. Please see the enteral nutrition formula section in this document.
What you need to know about sub-contracting under the Medicare Competitive Bidding program.
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