Non-contract suppliers that are renting competitively bid durable medical equipment (DME)* or oxygen and oxygen equipment at the time a round of competition begins for the DMEPOS Competitive Bidding Program may choose to become grandfathered suppliers for these items. A non-contract supplier that chooses to become a grandfathered supplier for any product category is required to grandfather all items within that product category to all Medicare beneficiaries who are renting the DME or oxygen and oxygen equipment at the time contracts for a given round of bidding become effective. The Round 2 Recompete contracts become effective on July 1, 2016.
Non-contract suppliers must provide written notification of their decision whether to become a grandfathered supplier to all of their Medicare beneficiaries who reside in a competitive bidding area (CBA) and are currently renting competitively bid DME or oxygen and oxygen equipment at least 30 business days prior to program implementation. The notification must inform the beneficiaries about their decision whether to grandfather and explain the grandfathering process and the beneficiaries' options.
*Rented DME items include standard nebulizers, standard manual wheelchairs, group 1 support surfaces, group 2 support surfaces, transcutaneous electrical nerve stimulation devices (TENS), commode chairs, patient lifts, seat lifts, negative pressure wound therapy (NPWT) pumps, continuous positive airway pressure devices (CPAPs), respiratory assist devices (RADs), walkers, standard power wheelchairs, scooters, and hospital beds.
In accordance with the final rule published on December 2, 2013 (78 FR 72224), the following items are being reclassified to the capped rental payment class effective July 1, 2016.
E0140 E0149 E0985 E1020 E1028 E2228 E2368
E2369 E2370 E2375 K0015 E0070 E0955 E0197
Items in the enteral nutrients, equipment and supplies product category and in the national mail-order program cannot be grandfathered.