| Antitrust Guidance (PDF, PDF - 93 KB)|
The antitrust laws protect competition and prohibit collusion. Price fixing, bid rigging, and other forms of collusion, including agreements to allocate customers or divide markets, are illegal...
|Billing Procedures for Upgrades|
Medicare payment for upgrades will be based upon the payment amount applicable to the item in the area in which the beneficiary resides...
| Change of Ownership - Guidelines and Responsibilities - Round 2 and National Mail-Order (PDF, PDF - 677 KB)|
A DMEPOS supplier participating in the competitive bidding program that is negotiating a change of ownership (CHOW) must notify CMS 60 days before the anticipated date of the change...
| Common Ownership or Control (PDF, PDF - 186 KB)|
Suppliers are prohibited from competing against themselves when submitting bids in the DMEPOS Competitive Bidding Program. Therefore, suppliers that are commonly owned or commonly controlled must submit one bid for the same product category in the same CBA...
| Competitive Bidding Areas (CBAs) (PDF, PDF - 107 KB)|
Fact sheet about the CBAs included in the Round 2 and national mail-order competitions...
| Contract Supplier Obligations (PDF, PDF - 208 KB)|
Contract suppliers are responsible for fulfilling all terms of their contracts, starting on the very first day of the contract period, for the duration of the contract period. Here are key contract terms with which contract suppliers must comply throughout the contract period.
| Covered Document Review Date (PDF, PDF - 114 KB)|
Suppliers that submit their financial documents by a deadline called the Covered Document Review Date (CDRD) will have their documents checked to determine if any individual financial documents are missing, will be notified of what is missing, and will have an opportunity to submit the missing documents...
|DMEPOS Quality Standards|
Medicare enrolled DMEPOS suppliers, including DMEPOS Competitive Bidding Program contract suppliers, must meet the DMEPOS quality standards.
| Eligibility Requirements (PDF, PDF - 118 KB)|
A supplier must meet certain eligibility requirements before it can submit a bid and be awarded a contract under the DMEPOS Competitive Bidding Program...
| Enteral Nutrition (PDF, PDF - 107 KB)|
With the exception of SNFs and NFs that become specialty suppliers, suppliers that are contract suppliers for the enteral nutrition product category must furnish services to beneficiaries throughout CBA, regardless of whether a beneficiary lives in a private residence or institutional setting...
| Exemptions from the Requirement to Be a Contract Supplier for Competitively Bid Items and Services - Round 2 and National Mail-Order (PDF, PDF - 124 KB)|
Non-contract suppliers that furnish competitively bid items in a CBA are not eligible for Medicare Part B payment for the competitively bid items for that CBA unless one or more exceptions apply.
| Grandfathering for Oxygen and Oxygen Equipment (PDF, PDF - 105 KB)|
Suppliers that are not awarded a competitive bidding contract for furnishing oxygen and oxygen equipment in a CBA can decide to be grandfathered suppliers for beneficiaries to whom they are furnishing these items at the time the competitive bidding program is implemented...
| Grandfathering for Rented DME (PDF, PDF - 91 KB)|
Suppliers that are not awarded a competitive bidding contract for furnishing rented DME in a CBA can decide to be grandfathered suppliers for beneficiaries to whom they are furnishing these items at the time the competitive bidding program is implemented...
|Grandfathering Requirements for Non-Contract Suppliers Fact Sheet|
Suppliers that are not awarded a competitive bidding contract for furnishing rented DME and/or oxygen and oxygen equipment in a CBA can decide to be grandfathered suppliers for beneficiaries to whom they are furnishing these items at the time the competitive bidding program is implemented.
|Hospitals That Are Not Contract Suppliers|
For the first phase of competitive bidding, one exception allows hospitals to furnish competitively bid walkers in a CBA to their own patients without submitting a bid and being selected as a contract supplier.
| Licensure for Bidding Suppliers (PDF, PDF - 60 KB)|
Suppliers submitting a bid for a product category in a CBA must meet all DMEPOS state licensure requirements and other applicable state licensure requirements, if any, for that product category for every state in that CBA...
| Licensure for Contract Suppliers (PDF, PDF - 98 KB)|
As a contract supplier for the Medicare DMEPOS Competitive Bidding Program, you must comply with all applicable state and local laws. This includes maintaining compliance with all applicable state and local licensing requirements pertaining to functions under your contract throughout the duration of the contract period...
|Physicians and Other Treating Practitioners Who Are Enrolled as Medicare DMEPOS Suppliers|
Physicians and other treating practitioners who are enrolled as Medicare DMEPOS suppliers may furnish certain competitively bid items in a CBA to their own patients without submitting a bid and being selected as a contract supplier if specific requirements are met.
| Prescription for Specific Brand or Mode of Delivery to Avoid an Adverse Medical Outcome (PDF, PDF - 124 KB)|
The Medicare DMEPOS Competitive Bidding Program includes a special beneficiary safeguard to ensure that beneficiaries have access to specific brands or modes of delivery of competitively bid items when needed to avoid an adverse medical outcome...
|Repairs and Replacements|
This fact sheet contains important information about repairs and replacements of beneficiary-owned equipment under the DMEPOS Competitive Bidding Program.
| Required Financial Documents (PDF, PDF - 205 KB)|
Detailed instructions about how to submit the required hardcopy financial documents...
| Requirement to Submit a Bona Fide Bid (PDF, PDF - 158 KB)|
The DMEPOS Competitive Bidding Program regulations require that each bidder must submit a bona fide bid that complies with all the terms and conditions specified in the request for bids (RFB)...
| Review of Supplier Capacity and Expansion Plans (PDF, PDF - 98 KB)|
This fact sheet describes how CMS conducts its review of supplier capacity and expansion plans during the bid evaluation process...
| Round 2 Items and Services (PDF, PDF - 110 KB)|
Fact sheet about the competitively bid items and services included in Round 2...
| Skilled Nursing Facilities (SNFs) and Nursing Facilities (NFs) (PDF, PDF - 122 KB)|
Skilled Nursing Facilities (SNFs) and Nursing Facilities (NFs) are subject to the Medicare DMEPOS Competitive Bidding Program to the extent that competitively bid items and services are furnished to their residents under Medicare Part B...
| Subcontracting of DMEPOS Services - Round 2 and National Mail-Order (PDF, PDF - 133 KB)|
The primary supplier is responsible for the overall service of furnishing the item and coordinating the care for the beneficiary in compliance with the physician’s order and Medicare rules and guidelines, but the primary supplier may subcontract certain services...
| Supplier Marketing Guidelines (PDF, PDF - 474 KB)|
All of the existing rules and regulations regarding marketing DMEPOS to beneficiaries under the fee-for-service program also apply to DMEPOS contract suppliers under competitive bidding...
|Traveling Beneficiary Fact Sheet|
This fact sheet is designed to provide education to Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) suppliers that provide items to Medicare beneficiaries who reside in or travel to competitive bidding areas. It includes information on how to determine whether a beneficiary is in a traveling status, how to properly bill Medicare for the item, and how Medicare will determine the payment amount.