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Educational Information

Medicare DMEPOS Competitive Bidding Program Form C Report

Form C is a report that you as a contract supplier complete each quarter to update your product information for the Supplier Directory on the Medicare website. The Supplier Directory is a useful marketing tool as beneficiaries, their caregivers, and the 1-800-MEDICARE customer service representatives use this information to locate contract suppliers that furnish specific brands of products.

Completion of Form C is also a requirement under the Medicare Competitive Bidding Program contract. Article VIII requires you to report manufacturer and model information for specific Healthcare Common Procedure Coding System (HCPCS) codes that you will offer during the next calendar quarter.

You will receive an e-mail notification each quarter when it’s time to submit Form C. Form C is due no later than ten calendar days after each of the following dates: March 31; June 30; September 30; and December 31, throughout the entire contract period. Therefore, the Competitive Bidding Implementation Contractor (CBIC) must receive your completed Form C no later than Wednesday, July 10, 2013. You must complete Form C for EVERY competitive bidding area (CBA)/product category combination included in your contract.

Form C for the third quarter of 2013 is now available on the CBIC website, www.DMECompetitiveBid.com. Select Round 2 & National Mail-Order from the menu on the left side of the homepage. Then select Form C in the Top Links box. As you prepare to submit Form C for Round 2, please go to the Supplier Directory at www.medicare.gov/supplierdirectory/search.html and review your company’s manufacturer information under "Manufacturers & Models Available." You provided this product information on your bid application in DBidS or the 50 percent compliance form for the national mail-order competition. Detailed instructions for completing and submitting Form C are also on the CBIC website.

If you have more than one contract (e.g., you are a contract supplier in both the Round 1 Rebid and Round 2), you only need to complete one form and can apply your product information to each contract number. Failure to submit a timely Form C for all CBA/product category combinations in your contract(s) may be considered a breach of contract and result in termination.

For more information about the quarterly report requirement, please call the CBIC customer service center at 877-577-5331 between 9 a.m. and 5:30 p.m. prevailing Eastern Time, Monday through Friday.

last updated on 03/25/2014


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