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Overview of Medicare Competitive Bidding for Prescribers

Medicare has changed the way it purchases home medical equipment (DME / HME). Under the new program Medicare will contract with only certain medical equipment suppliers in your area*. Beginning July 1, 2013 orders for the most commonly prescribed homecare products** must be sent to companies who have been awarded a contract under this program.

Background

In 2003 a law was passed that required Medicare to solicit bids from companies that provide home medical equipment. The purpose was to change the way the reimbursement for each item is calculated. Currently, the reimbursement for each item is arrived at by a fee schedule that is approved by Congress. The goals of the new system are to have the market set the pricing through a bidding program, and reduce costs to the Medicare program.

The result of the program is that bid winners are selected and offered contracts. Those companies who are awarded contracts are the only providers who can fill orders for Medicare beneficiaries (after 7/1/13).

Summary | What do I need to know?

New Medicare Program

Changes where DME referrals can be sent

DME referrals must be sent to contracted suppliers

Sub-Contracting

What you need to know about sub-contracting under the Medicare Competitive Bidding program.

Contractors

Best practices for finding and utilizing sub-contractors to grow your business.

Managed Care

Filling network holes caused by the Medicare Competitive Bidding Program.