Summary of CMS' Special ODF Bidder's Conference
Dear PMC Members:
The Centers for Medicare and Medicaid Services (CMS) held the third in a series of competitive bidding “bidder conferences” on the topic “What You Need to Know Before Submitting Your Bid.” CMS started the session by reminding providers that registration for Authorized Operators (AOs) has passed but providers can still register for the time being. Providers will have until October 10th to register Backup Authorized Operators (BAOs) and the online registration site will close on November 4th at 9pm (EST). No registrations or changes to registrations will be allowed after that date.
Key Contract Terms
Providers must be ready to comply with all terms of the awarded contract on Day 1 to the end of the contract period. The round 1 contract period will be announced when the bidding window opens.
Providers cannot discriminate and must offer the same items to all beneficiaries. Further, providers must furnish all items in the contract category to those beneficiaries who are residing or visiting a contracted bidding area. Providers also must provide the equipment specified by the physician in the prescription (so long as the equipment will lead to a favorable outcome). Lastly, providers must maintain enrollment standards, accreditation and licensure for the duration of the contract.
The rules that govern subcontractors, which was discussed in the last bidder’s forum, are also part of the contract terms.
Change of Ownership
Providers are prohibited from selling or assigning a competitive bidding contract. A provider can, however, merge or acquire a contracted provider but such a sale must adhere to all laws and be reported to CMS and the National Supplier Clearinghouse (NSC). CMS and the NSC will then review the sale and evaluate whether to extend the contract to the new ownership.
Traveling Beneficiaries
Payment is always based on the permanent residence of the beneficiaries. If a beneficiary from a non competitive bidding area (CBA) travels to a CBA and needs an item subjected to bid, then the beneficiary must purchase the item from a contracted provider and the provider would be reimbursed from the DME fee schedule (since the beneficiary lives in a non-CBA). Beneficiaries who travel to a non-CBA can purchase an item subject to bid from any provider but that provider will be reimbursed the single payment amount for the item in the beneficiaries CBA.
Next Bidder Conference
The fourth in the series of CMS’ bidder conferences will be held on Tuesday, September 22, 2009 from 2:00-3:00 pm (EST) on Financial Documentation and Small Provider Considerations. To access the call, dial 1-800-837-1935 and reference Conference ID: 23045166.
