Medicare Competitive Bidding

Patient Support

Like most people on Medicare, you probably have questions about the new Medicare Competitive Bidding Program. For instance, you may want to know how the process will affect you, what products and services are included under the program, and what you can do to ensure you have uninterrupted homecare provider service.

What is competitive bidding?

Competitive bidding is simply the term used by the Centers for Medicare and Medicaid Services (CMS) to describe the process that required durable medical equipment products and services (DMEPOS) providers to bid on the right to service patients within certain competitive bidding areas across the United States.

Only certain DMEPOS providers that met CMS criteria were eligible to become Medicare contracted providers. The goals of competitive bidding were to limit the number of service providers, reduce CMS administrative costs, reduce the cost of products and services covered by Medicare, and ensure quality.

Where are the competitive bidding areas?

There are nine Medicare competitive bidding areas in the first round of bidding. They are:

  1. Cincinnati-Middletown (Ohio, Kentucky and Indiana)
  2. Cleveland-Elyria-Mentor (Ohio)
  3. Charlotte-Gastonia-Concord (North Carolina and South Carolina)
  4. Dallas-Fort Worth-Arlington (Texas)
  5. Kansas City (Missouri and Kansas)
  6. Miami-Fort Lauderdale-Palm Beach (Florida)
  7. Orlando-Kissimmee (Florida)
  8. Pittsburgh (Pennsylvania)
  9. Riverside-San Bernardino-Ontario (California)

Apria Healthcare is proud to announce it has been awarded Medicare contracts in all nine CBAs to provide enteral nutrition products and services. For more information abut our services in your area, please use the Branch Locator to find the branch nearest you.

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What products and services are included in the competitive bid process?

Products covered by competitive bidding include oxygen, CPAP/Bi-level, diabetes supplies, complex power wheelchairs, standard power wheelchairs, hospital beds, walkers, and support surfaces. Enteral nutrition (tube feeding) supplies and pumps are also covered under competitive bidding; however, total parenteral nutrition (TPN) and other homecare infusion therapy is not.


What do I need to do if I'm a Medicare Part B beneficiary?

If you are a Medicare Part B primary beneficiary in a competitive bidding area (CBA), you will be required to use a Medicare contracted DMEPOS provider for enteral nutrients after January 1, 2011. If your current provider won a contract in your CBA, you may not have to change providers. However, if your provider is not awarded a Medicare contract as a provider of enteral nutrients (i.e., tube feeding) after January 2011, you must choose another service provider by the end of 2010.

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What if I have Medicare Advantage or Medicare as a secondary payor?

Competitive bidding affects only those patients where Medicare Part B is their prmary payor. Patients with Medicare Advantage, Medicare secondary, managed care, or commercial payors are not affected.

How do I find out if the CMS competitive bidding program affects me?

You can email CMS at dmepos_qa@cms.hhs.gov with questions about transitioning to a contracted provider or to report issues. You can also visit www.cms.hhs.gov/CompetitiveAcqforDMEPOS for more information. Please contact the Apria branch nearest you for more information, by using the Branch Locator feature of this website.

Where can I find out more information about the Medicare Competitive Bidding Program?

You can learn more about the Medicare Competitive Bidding Program and get up-to-date information at www.apriamedicarecontracts.com.

 

Apria Healthcare stands ready to help you through this process

Apria is ready to assist and support all Medicare patients in the competitive bidding areas. With more than 30 years of nutrition expertise and a clinical staff of registered dietitians available to work with you, we are one of the leading home tube feeding providers in the U.S., servicing more than 25,000 enteral nutrition patients each month, Apria has over 500 branches nationwide, ensuring there's a branch near you. Call Apria Healthcare's dedicated tube feeding nutrition support team toll-free at 866.396.0619, or visit us at www.apria.com.

To learn more about our tube feeding program, contact us today.