On July 1, 2013, Medicare is implementing significant changes to the structure of its supplier network for Durable Medical Equipment, Prosthetics, Orthotics, and supplies (DMEPOS) under their “Competitive Bidding Program,” while also implementing a national mail order program for diabetic testing supplies. Medicare began this program in certain areas in January, 2011. This is an extension – or “Phase II” – of this program.
The program changes the amount Medicare pays suppliers for certain durable medical equipment, prosthetics, orthotics and supplies. It also changes who can supply these items. In order for Medicare to help pay for these items, original Medicare members will almost always have to use a Medicare contract supplier. In early May 2013, CMS mailed all Medicare members a letter notifying them of this change. Click here to view the letter.
To find an approved supplier near you, Blue Cross Blue Shield members can call 1-888-722-0322. All others can call the number referenced on the back of their health plan ID card.
To see if your area is impacted, click here for a list of service areas affected by Phase II.
The following is a list of durable medical equipment, prosthetics, orthotics and supplies included in the competitive bidding program:
- Oxygen, oxygen equipment, and supplies
- Standard power wheelchairs, scooters, and related accessories
- Complex rehabilitative power wheelchairs and related accessories
- Mail-order diabetic supplies (all zip codes are affected)
- Enteral nutrients, equipment, and supplies
- Continuous Positive Airway Pressure (CPAP) devices and Respiratory Assist Devices (RADs), and related supplies and accessories
- Hospital beds and related accessories
- Walkers and related accessories
- Support surfaces (Group 2 mattresses and overlays)
In addition to this list, Medicare members must use an approved mail order or retail supplier for diabetic testing supplies (lancets, testing strips and monitors). In early May 2013, CMS mailed all Medicare members a letter notifying them of this change. Click here to view that letter.
For a list of the Medicare Competitive Bid National Mail Order providers with their phone numbers, click here.
Note: If original members travel to any of the Phase II areas (regardless of their primary residence), they must get their equipment/supplies from a Medicare competitive bidding approved supplier.
Common questions on these changes.