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Author: United States. Congress. House. Committee on Ways and Means. Subcommittee on Health
Publisher:
ISBN:
Category : Business & Economics
Languages : en
Pages : 152
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Book Description
Author: United States. Congress. House. Committee on Ways and Means. Subcommittee on Health
Publisher:
ISBN:
Category : Business & Economics
Languages : en
Pages : 152
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Book Description
Author: U. S. Department Human Services
Publisher: CreateSpace
ISBN: 9781493511594
Category :
Languages : en
Pages : 32
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Book Description
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 The program replaces the outdated, inflated fee-schedule prices Medicare is currently paying with lower, more accurate prices.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.
Author: United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Health
Publisher:
ISBN:
Category : Letting of contracts
Languages : en
Pages : 232
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Author: United States House of Representatives
Publisher:
ISBN: 9781697973198
Category :
Languages : en
Pages : 152
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Medicare's DMEPOS Competitive Bidding Program: hearing before the Subcommittee on Health of the Committee on Ways and Means, U.S. House of Representatives, One Hundred Tenth Congress, second session, May 6, 2008.
Author: Centers for Medicare & Medicaid Services (U.S.)
Publisher:
ISBN:
Category : Medical supplies
Languages : en
Pages : 32
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Book Description
Author: Kathleen M. King
Publisher: DIANE Publishing
ISBN: 1437926851
Category : Health & Fitness
Languages : en
Pages : 65
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Book Description
In 2007, Medicare spent $8.3 billion for durable medical equipment (DME) and related supplies. To reduce spending, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) required that the Centers for Medicare and Medicaid Services (CMS) phase in a competitive bidding program (CBP) for DME and other items. DME suppliers began bidding in round 1 of the CBP in May 2007. After contracts were awarded, the Medicare Improvements for Patients and Providers Act of 2008 was enacted in July 2008. This report examined: (1) the results of CBP round 1; (2) the major challenges CMS had in conducting CBP round 1; and (3) the steps CMS has taken to improve future CBP rounds. Charts and tables.
Author: Kathleen M. King
Publisher: DIANE Publishing
ISBN: 1437988490
Category : Medical
Languages : en
Pages : 29
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Book Description
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.
Author: United States. Government Accountability Office
Publisher:
ISBN:
Category : Medical instruments and apparatus industry
Languages : en
Pages : 42
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Author:
Publisher: DIANE Publishing
ISBN: 1428937218
Category :
Languages : en
Pages : 36
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Author: U.s. Government Accountability Office
Publisher:
ISBN: 9781974227501
Category :
Languages : en
Pages : 74
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"To achieve Medicare savings for DME, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) required that CMS implement the CBP for certain DME. In 2008, the Medicare Improvements for Patients and Providers Act (MIPPA) 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 January 1, 2011. CMS has estimated that the rebid will lead to significant savings for Medicare.MIPPA requires GAO to examine certain aspects of the CBP. In this report, GAO 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.To examine CBP outcomes and effects, GAO analyzed data from CMS and its feedback provided to bidding suppliers, analyzed 2011 CBP data about different types of suppliers, and interviewed CMS and CBP contractor officials, DME industry groups, and suppliers. To examine CBP's effects on beneficiary access, GAO analyzed Medicare claims data for the first six months of 2011 because the data for those months were the most complete, and compared it to the same months"
