Licensure for Bidders Fact Sheet
On April 9, 2020, the non-invasive ventilators product category was removed from Round 2021 due to the novel COVID-19 pandemic. On October 27, 2020, the Centers for Medicare & Medicaid Services (CMS) announced the single payment amounts and began offering contracts for the off-the-shelf (OTS) back braces and OTS knee braces product categories. All other product categories were removed from Round 2021. Please see the CMS announcement for additional information.
A bidder must have all applicable state licenses required to furnish all items in the product category in which it submits a bid. This requirement is a condition for awarding a contract.
As part of the bid evaluation process, CMS will verify with the Provider Enrollment, Chain, and Ownership System (PECOS) that each location, (identified by a Provider Transaction Access Number (PTAN)) listed on Form A of the online Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Bidding System (DBidS), has the required state license(s) to furnish the lead item and non-lead items in a product category for the particular competitive bidding area (CBA).
Therefore, a bidder must have current, non-expired state licenses for each supplier location in PECOS by the close of the bid window to be eligible for a competitive bidding contract.
NOTE: In prior rounds of the DMEPOS Competitive Bidding Program, if a bidder included multiple locations (identified by a PTAN) on a bid for a CBA and product category combination, those locations could collectively meet the state licensing requirements for the larger product categories including multiple products (e.g., general home equipment product category). However, in Round 2021 some items and services have been shifted to different, smaller product categories to accommodate the lead item pricing methodology. As a result of these smaller product categories, each individual location on a bid must meet all state licensing requirements for every item in the product category to be considered for a contract. For instance, if a state has different licensing requirements to furnish continuous positive airway pressure (CPAP) devices and/or supplies than it does to furnish respiratory assist devices (RADs), each location on the supplier’s bid will need to meet the licensing requirements to furnish both RADs and CPAP devices and/or supplies.
In addition, bidders must ensure their CMS-855S enrollment application is up to date with the National Supplier Clearinghouse (NSC) and that it is reflected in PECOS for the states and products the supplier currently furnishes or plans to furnish if awarded a DMEPOS competitive bidding contract.
A DMEPOS State License Directory for each state, the District of Columbia, and the US territories may be found on the NSC website. This directory provides general licensing requirements for DMEPOS product categories and contact information for each state’s licensing board or agency. This is only a guide. Licensing requirements change periodically, and it remains the responsibility of the bidder to identify, obtain, and have all current, non-expired required state licenses reflected in PECOS by the close of the bid window. For more information about licensing requirements, please consult the appropriate state licensing board/agency.
Contract suppliers are required to maintain compliance with all state licensing requirements throughout the duration of the contract period. If a supplier is awarded a contract for a CBA and product category combination (competition) and a location submitted in DBidS is not included on the contract for that competition, the location was removed from the awarded competition because it did not meet one or more bidding requirements. Bidders cannot request its bid be re-reviewed through a bidder inquiry to add the location to an awarded competition.
Suppliers should instead submit a Change of Location (COL) request in Connexion for the location(s), regardless if it was originally on its bid for the competition to be added to its contract.
- If the COL request is submitted prior to the implementation of the round and all enrollment requirements for the location are met, the qualified location will be added to the awarded competition and the effective date of this addition will be the start date of the contract period.
- If the COL request is received after the implementation of the round and all enrollment requirements for the location are met, the effective date of this addition will be the date the COL request is received.
- If the COL request is received after the implementation of the round but all enrollment requirements for a location are not met, the effective date for the location to be added to the contract will be the effective date in PECOS when all requirements are met.