Competitive Bidding Ignites Some Important Issues

With CMS’ “Late Fall” competitive bidding bid window opening soon, providers should be aware of some important issues.

Medtrade states that: “Suppliers intending to submit bids for the DMEPOS remote item delivery (RID) competitive bidding program (CBP) will have to be in compliance with all pre-requisites by the close of the bid window.”

So, what do providers NEED to know as the “Late Fall” competitive bidding window approaches?

1. Compliance with all U.S. state and territory licensure requirements is required.

1. According to Medtrade, “all locations on a supplier’s bid must collectively meet all applicable licensing requirements for every item in the product category in which the bidder bids. “
   1. During the bid evaluation process, CMS will use PECOS to check bidders’ licenses.
   2. State licensure information can be found on NPEast and NPWest, the CMS enrollment contractor web sites. These are a good starting point for DMEPOS suppliers. It’s important to note, however, that these databases are only a guide and that licensing rules are subject to change. Thus, providers would be prudent to ensure licenses are current by the close of the bid window. Medtrade emphasizes: “Most important is that bidders confirm directly with legal counsel and/or the state licensing agencies to confirm their licensing requirements.”

2. The six-month transition period that starts when RID contracts begin.

On CMS' competitive bid website, CMS has stated that there is a “six-month transition (grace) period for contract suppliers to obtain written orders for patients transitioning to them from non-contract suppliers beginning on or after January 1, 2028.”

This policy present a few practical issues. Medtrade sums them up well:

From an audit perspective, how will CMS and its audit contractors identify claims where the signed order is after the date of service as part of this transition policy? How will CMS ensure these claims will not be overturned? On a more immediate basis, how will contract suppliers know, during the transition period, if the beneficiary qualifies for the item? How will contract suppliers know if the beneficiary had a physician visit within the last year to recertify medical need? Contract suppliers will need some assurance that the beneficiary meets the medical need criteria.

Follow along here at dmeflow.ai for updates information on the RID competitive bidding program!

For additional information, also visit the government’s web site at www.dmecompetitivebid.com and AAHomecare’s site at www.aahomecare.org.