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On Thursday, May 25, 2023, CMS announced that the DMEPOS Competitive Bidding Program will begin a temporary gap period, starting January 1, 2024. In the weekly Medicare Learning Network (MLN) MLNConnects newsletter, CMS provided details on the current Competitive Bidding Program and the future of competitive bidding. 

All DMEPOS Competitive Bidding Program (CBP) Round 2021 contracts for off-the-shelf (OTS) back and knee braces will expire on December 31, 2023. Starting January 1, 2024, there will be a temporary gap period for the DMEPOS CBP.

CMS indicated that they will start bidding for the next round of the DMEPOS CBP after they have:

  • Completed the formal public notice and comment rulemaking process
  • Implemented necessary DMEPOS CBP changes to:
    • Establish sustainable prices
    • Save money for Medicare patients and taxpayers
    • Help limit fraud, waste, and abuse in the Medicare Program
    • Ensure patient access to quality items and services

During the temporary gap period, Medicare-enrolled DMEPOS suppliers may furnish DMEPOS items and services to patients. Here are the payment rules:

  • Adjusted fees in former competitive bidding areas (CBAs) are based on 100% of the single payment amount for the CBA increased by the projected percentage change in the Consumer Price Index for All Urban Consumers (CPI-U) from January 2023 - January 2024 
  • Adjusted fees in non-CBAs are based on fully adjusted rates per the applicable methodology under  42 CFR 414.210(g)

To review this MLN Fact Sheet, click here.

The van Halem Group will continue to monitor this information closely and provide details as they develop. 

Did you know that our experts provide Competitive Bidding Consultation Services? Contact us to learn more!