Eligibility Requirements Fact Sheet
Bidders must meet certain eligibility requirements when submitting a bid to be awarded a contract under the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program.
- All bidders are required, pursuant to 42 CFR §414.412(g), to obtain a $50,000 bid surety bond from an authorized surety on the Department of the Treasury’s List of Certified Companies for each competitive bidding area (CBA) for which they submit a bid. Bidders must provide proof of having obtained the required bond(s) by uploading a copy of the bond(s) in Connexion, the program’s secure portal, by the close of the bid window. Please see the Bid Surety Bond page for more information.
- Bidders must submit the applicable covered documents (as defined in 42 CFR §414.402) specified in the Request for Bid Instructions and meet the minimum financial threshold required by the Centers for Medicare & Medicaid Services (CMS). Please refer to the Required Financial Documents page for additional information.
- Bidders must be DMEPOS suppliers in good standing with the National Supplier Clearinghouse (NSC) and possess an active Provider Transaction Access Number (PTAN) for each location listed on their bid(s).
- Bidders must have their CMS-855S enrollment application up to date with the NSC and reflected in the Provider Enrollment, Chain, and Ownership System (PECOS) for the states and products they currently furnish or plan to furnish if awarded a competitive bidding contract. It is imperative that the bidders’ PECOS records are up to date with current and accurate information, as information in PECOS will be verified during the registration and bidding process.
- Bidders must be accredited by a Centers for Medicare & Medicaid Services (CMS) approved accrediting organization for the lead item and all non-lead items in each product category for which they submit a bid. CMS cannot award contracts to bidders that are not accredited. It is important to note that accreditation exemptions are not applicable for participation in the Medicare DMEPOS Competitive Bidding Program. Additionally, each supplier location (identified by PTAN) on a bid must be accredited for every item in the product category to be included on a contract. A listing of CMS approved accrediting organizations is on the CMS website.
- CMS cannot award contracts to bidders that do not meet all applicable state licensing requirements. Bidders must have all current, non-expired licensing information for all required licenses reflected in PECOS by the close of the bid window. Each individual supplier location on a bid must meet all applicable state licensing requirements for every item in the product category. For more information about licensing requirements and exemption information, please see the licensure directory on the NSC website, and the Licensure for Bidders fact sheet.
- Contract suppliers must be ready to furnish items and services in the CBA on day one of the contract period. Only locations included on Attachment B of the supplier’s contract are eligible for Medicare payment for competitively bid items at the time Round 2021 begins. Contract suppliers may request that locations be added or removed from their contracts at any time during the contract period by submitting a Change of Location (COL) request in Connexion. However, contract suppliers cannot furnish items under a contract using any new location added through the COL process until CMS has confirmed the location(s) meets all applicable requirements and the necessary updates to the enrollment and claims processing systems have been completed.
- Contract suppliers may use a subcontractor to assist with carrying out certain terms of the competitive bidding contract. Per the DMEPOS Supplier Standards, outlined in 42 CFR §424.57, contract suppliers may only use a subcontractor for:
- purchase of inventory,
- maintenance and repair of rented equipment,
- delivery only of a Medicare covered item, and
- setup and/or instruction on use of a Medicare covered item.
- Contract suppliers are responsible for the items and services they furnish directly or through the use of a subcontractor. This includes maintaining proper documentation and ensuring appropriate delivery, setup, and/or instruction. For additional information, please see the Subcontracting of DMEPOS Services fact sheet.