On Tuesday, October 27, 2021, CMS announced single payment amounts for just two products included in the Round 2021 bid program set to begin next year. CMS reviewed over 49,000 bid applications across 16 different product categories in 130 competitive bid areas (CBAs). In the end, however, only 235 product-area competitions survived out of the thousands included at the outset of the program.
That leaves a huge supplier community with obsolete operational budgets and fossilized expectations for next year. Suppliers that planned for the exclusivity of a contract used assumptions about revenue, purchasing, and personnel that are no longer reliable. Those, on the other hand, that planned to exit certain CBAs find themselves in a race to determine the wisdom of engaging under the substituted reimbursement structure.
Round 2021 set out to competitively bid – and establish sustainable, market-based rates for – 16 product categories under a revised program designed to fix systemic flaws in previous competitions.
In April, shortly after the COVID-19 pandemic hit the US, CMS removed non-invasive ventilators over concerns the program might limit beneficiary access to life-saving equipment already in short supply.
Then, after months of silence, CMS removed 13 additional products “... because payment amounts did not achieve expected savings.” Products eliminated included:
And that is how 16 products became two:
The competitive bidding announcement, along with the subsequently released 2021 DME Final Rule, leave virtually no supplier’s reimbursement rates unchanged and no expectation intact. And that kinda changes everything.
SOURCE LINKS
https://www.cms.gov/files/document/round-2021-dmepos-cbp-single-payment-amts-fact-sheet.pdf
https://www.dmecompetitivebid.com//cbic/cbic2021.nsf/DID/84U18RR1ER
That leaves a huge supplier community with obsolete operational budgets and fossilized expectations for next year. Suppliers that planned for the exclusivity of a contract used assumptions about revenue, purchasing, and personnel that are no longer reliable. Those, on the other hand, that planned to exit certain CBAs find themselves in a race to determine the wisdom of engaging under the substituted reimbursement structure.
Round 2021 set out to competitively bid – and establish sustainable, market-based rates for – 16 product categories under a revised program designed to fix systemic flaws in previous competitions.
In April, shortly after the COVID-19 pandemic hit the US, CMS removed non-invasive ventilators over concerns the program might limit beneficiary access to life-saving equipment already in short supply.
Then, after months of silence, CMS removed 13 additional products “... because payment amounts did not achieve expected savings.” Products eliminated included:
- Commodes.
- PAP/RAD.
- Enteral.
- Hospital beds.
- Nebulizers.
- Negative pressure wound therapy.
- Oxygen.
- Patient lifts and seat lifts.
- Manual wheelchairs.
- Power wheelchairs.
- Support surfaces.
- TENS.
- Walkers.
And that is how 16 products became two:
- Off-the-shelf knee braces.
- Off-the-shelf back braces.
The competitive bidding announcement, along with the subsequently released 2021 DME Final Rule, leave virtually no supplier’s reimbursement rates unchanged and no expectation intact. And that kinda changes everything.
SOURCE LINKS
https://www.cms.gov/files/document/round-2021-dmepos-cbp-single-payment-amts-fact-sheet.pdf
https://www.dmecompetitivebid.com//cbic/cbic2021.nsf/DID/84U18RR1ER
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