Download or read book Your Guide to Medicare s Durable Medical Equipment Prosthetics Orthotics and Supplies DMEPOS Competitive Bidding Program written by U. S. Department Human Services and published by CreateSpace. This book was released on 2013-10 with total page 32 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicare's Competitive Bidding Program for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) changes the amount Medicare pays for certain DMEPOS items and makes changes to which suppliers Medicare will pay to supply these items to you. The first phase of the program is already in effect in 9 areas of the country. Starting July 2013, Medicare is scheduled to expand the competitive bidding program to more areas. The program replaces the outdated, inflated fee-schedule prices Medicare is currently paying with lower, more accurate prices. Under this program, suppliers submit bids to provide certain medical equipment and supplies at a lower price than what Medicare pays for these items now. Medicare uses these bids to set the amount it will pay for those equipment and supplies under the competitive bidding program. Qualified, accredited suppliers with winning bids are chosen as Medicare contract suppliers. The program: Helps you and Medicare save money; Ensures that you have access to quality medical equipment, supplies, and services from suppliers you can trust; Helps limit fraud and abuse in the Medicare Program. If you have Original Medicare, live in one of the competitive bidding areas, and use equipment or supplies included under the program (or get the items while visiting a competitive bidding area), you generally must use Medicare contract suppliers if you want Medicare to help pay for the item. If you live in one of the areas where the program is expanding and you're renting oxygen or certain other durable medical equipment (DME) at the time the program starts, you'll be able to continue renting these items from your current supplier if that supplier becomes a contract supplier or decides to participate in the program as a "grandfathered" supplier. If you live in (or get these items while visiting) these areas and don't use a Medicare contract or a grandfathered supplier, Medicare won't pay for the item, and you may have to pay full price. It's important to know if you're affected by this program to make sure Medicare will help pay for your item and to avoid any disruption of service. The competitive bidding program applies to Original Medicare only. If you're enrolled in a Medicare Advantage Plan (like an HMO or PPO), your plan will notify you if your supplier is changing. If you're not sure, contact your plan. Also available in Spanish.
Download or read book Your Guide to Medicare s Durable Medical Equipment Prosthetics Orthotics and Supplies DMEPOS Competitive Bidding Program written by Centers for Medicare & Medicaid Services (U.S.) and published by . This book was released on 2015 with total page 32 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicare Issues for Manufacturer Level Bidding for Durable Medical Equipment written by Kathleen M. King and published by DIANE Publishing. This book was released on 2012-10-19 with total page 29 pages. Available in PDF, EPUB and Kindle. Book excerpt: In 2009, Medicare spent approx. $8.1 billion on durable medical equipment (DME), prosthetics, orthotics, and related supplies for 10.6 million beneficiaries. DME includes items such as wheelchairs, hospital beds, and walkers. Medicare beneficiaries typically obtain DME items from suppliers, who submit claims for payment for these items to Medicare on behalf of beneficiaries. The Centers for Medicare & Medicaid Services (CMS), an agency within the Dept. of Health and Human Services (HHS), has responsibility for administering the Medicare program. Medicare and its beneficiaries -- through their out-of-pocket costs -- have sometimes paid higher than market rates for various medical equipment and supplies. To achieve Medicare savings for DME and to address DME fraud concerns, Congress required CMS to phase in a competitive bidding program (CBP) for DME suppliers in selected competitive bidding areas (CBA). In CBP, suppliers submit bid prices in the amounts they are willing to accept as payment to provide DME items to Medicare beneficiaries. CMS then enters into contracts with select DME suppliers to provide DME items at the prices determined by CBP. In contrast to CBP's supplier-level approach, some health care purchasers use a manufacturer-level approach to buy DME items directly from DME manufacturers to obtain savings by leveraging their purchasing power. CMS has not been required to develop a manufacturer-level approach. This report provides information on health care purchasers that currently use a manufacturer-level approach and on issues that would need to be addressed if CMS implemented such an approach. It describes (1) efforts used by some non- Medicare purchasers to reduce DME spending by contracting with DME manufacturers or using purchasing intermediaries, and (2) issues that CMS might face if required to implement a DME manufacturer-level approach with broad authority to do so. Figures and tables. This is a print on demand report.
Download or read book Medicare s Competitive Bidding Program for Durable Medical Equipment written by United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Health and published by . This book was released on 2013 with total page 212 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicare written by Kathleen M. King and published by . This book was released on 2015-02-08 with total page 57 pages. Available in PDF, EPUB and Kindle. Book excerpt: To achieve Medicare savings for durable medical equipment (DME), the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 required that the Centers for Medicare & Medicaid Services (CMS) implement the competitive bidding program (CBP) for certain DME. The first completed CBP round -- the round 1 rebid -- operated in nine competitive bidding areas. CMS reported total savings of more than $580 million at the end of the round 1 rebid's 3-year term due to lower payments and decreased utilization. This report examines (1) bidding process results for the round 1 recompete, round 2, and national mail-order program, and how they compare to the concluded round 1 rebid results; and (2) how single payment amounts (SPAs) for selected Healthcare Common Procedure Coding System (HCPCS) codes common to the round 1 rebid, round 1 recompete, round 2, and national mail-order program compare. Tables and figures. This is a print on demand report.
Download or read book Subcommittee Hearing on Competitive Bidding for Durable Medical Equipment written by United States. Congress. House. Committee on Small Business. Subcommittee on Rural and Urban Entrepreneurship and published by . This book was released on 2008 with total page 196 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicares Durable Medical Equipment Competitive Bidding Program written by United States. Congress and published by Createspace Independent Publishing Platform. This book was released on 2017-10-05 with total page 146 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicare's Durable Medical Equipment Competitive Bidding Program : how are small suppliers faring? : hearing before the Subcommittee on Healthcare and Technology of the Committee on Small Business, United States House of Representatives, One Hundred Twelfth Congress, second session, hearing held September 11, 2012.
Download or read book Medicare Durable Medical Equipment written by and published by . This book was released on 2013 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicare written by Government Accountability Office and published by CreateSpace. This book was released on 2013-09-12 with total page 74 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicare pays for most DMEPOS through fee schedules based on suppliers' previous charges to Medicare. The fee schedule payment is generally equal to 80 percent of the lesser of either the supplier's actual charge or the Medicare fee schedule for a particular item or service. In general, Medicare beneficiaries are responsible for paying the supplier the remaining 20 percent—the coinsurance.
Download or read book Subcommittee Hearing on the Impact of Competitive Bidding on Small Businesses in the Durable Medical Equipment Community written by United States. Congress. House. Committee on Small Business. Subcommittee on Rural Development, Entrepreneurship, and Trade and published by . This book was released on 2009 with total page 176 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicare written by Kathleen King and published by . This book was released on 2012-06-20 with total page 74 pages. Available in PDF, EPUB and Kindle. Book excerpt: To achieve Medicare savings for DME, an Act required that the CMS implement the competitive bidding program (CBP) for certain DME. In 2008, an Act terminated the first round of supplier contracts and required CMS to repeat the CBP round 1 -- referred to as the round 1 rebid, resulting in the award of contracts to suppliers with payments that began Jan. 1, 2011. This report reviews: (1) the outcomes of the CBP round 1 rebid process; (2) the effect of the CBP round 1 rebid on DME suppliers; (3) how the CBP round 1 rebid has affected Medicare beneficiary access to and satisfaction with selected DME; and (4) the extent to which the CBP round 1 rebid has affected the utilization of selected DME items. Illustrations. This is a print on demand report.
Download or read book Medicare s Durable Medical Equipment Competitive Bidding Program written by United States. Congress. House. Committee on Small Business. Subcommittee on Healthcare and Technology and published by . This book was released on 2012 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Subcommittee Hearing on Competitive Bidding for Durable Medical Equipment written by United States. Congress. House. Committee on Small Business. Subcommittee on Investigations and Oversight and published by . This book was released on 2007 with total page 160 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Getting the Price Right written by Hui Ding and published by . This book was released on 2021 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: We study Medicare's competitive bidding program (CBP) for durable medical equipment (DME). We exploit Medicare claims data to examine both prices and utilization, focusing on continuous positive airway pressure (CPAP) devices to treat sleep apnea. We find that spending falls by 47.2% percent after a highly imperfect bidding mechanism is introduced. The effect is almost entirely driven by a 44.8% price reduction, though quantities also fall by 4.3%. To disentangle supply and demand, we leverage differential cost sharing across Medicare recipients. We measure a demand elasticity of -0.272 and find that quantity reductions are concentrated among less clinically appropriate groups.
Download or read book Getting the Price Right The Impact of Competitive Bidding in the Medicare Program written by Hui Ding and published by . This book was released on 2021 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: We study Medicare's competitive bidding program (CBP) for durable medical equipment (DME). We exploit Medicare claims data to examine both prices and utilization, focusing on continuous positive airway pressure (CPAP) devices to treat sleep apnea. We find that spending falls by 47.2% percent after a highly imperfect bidding mechanism is introduced. The effect is almost entirely driven by a 44.8% price reduction, though quantities also fall by 4.3%. To disentangle supply and demand, we leverage differential cost sharing across Medicare recipients. We measure a demand elasticity of -0.272 and find that quantity reductions are concentrated among less clinically appropriate groups.
Download or read book Auctioning Healthcare written by Jim J. Tozzi and published by . This book was released on 2016 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicare's competitive bidding regulations for Durable Medical Equipment (DME) create an acquisition program that has the form, but not the function, of an auction. Federal and academic experts have explained that CMS' design for the bidding program violates accepted tenets of auction theory, selects an essentially random set of vendors, and results in a supply situation that is not viable. The goal of this document is to assess the consequences of two unorthodox decisions made by CMS in designing the program: 1) permitting non-binding bids; and 2) setting price equal to the median accepted bid. As the paper explains, these two rules result in CMS continuing to function in a price setting role - the antithesis of what auctions are intended to achieve. CMS' approach to competitive bidding is in sharp contrast to that of the Federal Communications Commission. When the FCC was confronted with the need to develop an auction program, they: 1. Sought the input on auction procedures from game theorists; and 2. Subjected their proposed auction procedures to review by a “Clinical Trial,” i.e, by having auction specialists conduct simulations to assess its strengths and weaknesses and to recommend modifications. Accordingly, CMS should reform its bidding program to correct the fundamental problems on which there is broad consensus. Consequently, prior to Round 2 of the DME competitive bidding program, the agency should subject its DME bidding program to a Clinical Trial comparable to that conducted by the FCC.
Download or read book Durable Medical Equipment written by United States. Congress. Senate. Committee on Appropriations. Subcommittee on Departments of Labor, Health and Human Services, Education, and Related Agencies and published by . This book was released on 1995 with total page 104 pages. Available in PDF, EPUB and Kindle. Book excerpt: Distributed to some depository libraries in microfiche.
