Posted in Industry Events & News | Comments OffCMS Releases SPAs for Round 1 Recompete

The CBIC posted the newly released single payment amounts for the Round 1 Recompete on October 1st. As a part of the Competitive Bidding program CMS is required to “recompete” contracts at least once every three years. Round 1 of Competitive Bidding affects nine metropolitan areas. While it initially began with a false start, it was re-launched as the Round 1 Rebid program which officially took effect on January 1, 2011. The existing contracts under Round 1 Rebid will expire on December 31, 2013. With the announcement of payment rates for the next round of competition, CMS will take the next three months to establish contracts and educate providers before the Round 1 Recompete launches on January 1, 2014. A total of 16 products are affected by Round 1 Recompete which CMS has broken into six categories. 

Those products are:

• Respiratory Equipment & Related Supplies & Accessories
  • Oxygen Equipment & Supplies
  • CPAP Equipment, Supplies & Accessories
  • Respiratory Assist Devices, Supplies & Accessories
  • Standard Nebulizers
• Standard Mobility Equipment & Related Accessories
  • Walkers & Accessories
  • Standard Power Wheelchairs, Scooters & Accessories
  • Manual Wheelchairs & Accessories
• General Home Equipment & Related Supplies & Accessories
  • Hospital Beds & Accessories
  • Group 1 & Group 2 Support Surfaces
  • TENS Units
  • Commode Chairs
  • Patient Lifts
  • Seat Lift Mechanisms
• Enteral Nutrients, Equipment & Supplies
• Negative Pressure Wound Therapy Pumps, Related Supplies & Accessories
• External Infusion Pumps & Supplies

According to the release, single payment amounts for the Round 1 Recompete show an average reduction of 37% off of the traditional fee schedule amounts. However, specific product categories are seeing cuts as deep as 47% off of fee schedule amounts. The steepest reimbursement reduction appears to be in the general DME category for the Riverside-San Bernardino-Ontario CA Competitive Bidding Areas (CBA), where rates were cut by 56%. CMS did issue a breakdown of the number of contract offers they expect to award by CBA and product category which can be accessed here. Until the contract offers are formally accepted and fulfilled, we will not know who the contracted providers will be, the final number of awarded contracts and/or locations serving beneficiaries in these nine areas. If a provider declines a contract, CMS will extend offers to other eligible providers that did not make the initial cut.

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