CMS Competitive Bidding Showing Savings

CMS issued an update in April about the state of the controversial competitive bidding program for durable medical equipment, prosthetics, orthotics, and supplies.

According to the report, it has saved the Medicare Fee-for-Service program approximately $202.11 million in its first year of implementation, a percentage drop in expenditures of over 42 percent in the nine markets currently participating in the program.

In addition, CMS reports that there has been no disruption in access to needed supplies for Medicare beneficiaries and no negative health care consequences to beneficiaries as a result of competitive bidding.

In 2013, the program will be expanded to an additional 91 metropolitan areas and a national mail order program for diabetic testing supplies. The CMS Office of the Actuary (OACT) estimates that the program will save the Medicare Part B Trust Fund $25.7 billion between 2013 and 2022. Beneficiaries are expected to save an estimated $17.1 billion during the same 10-year period due to the reduction in coinsurance reduced premiums.

Critics of the program say it restricts the number of companies that are allowed to provide equipment and supplies. They worry that low bidders will be selected who in turn use lower cost and perhaps lower quality supplies in order to make a profit. CMS on the other hand is confident in its success and perhaps they now have the numbers to back that up.

In related news, issued a final rule that requires all providers of medical or other items or services and suppliers that qualify for a National Provider Identifier (NPI) to include their NPI on all applications to enroll in the Medicare and Medicaid programs and on all claims for payment submitted under the Medicare and Medicaid programs. In addition, it requires physicians and other professionals who are permitted to order and certify covered items and services for Medicare beneficiaries to be enrolled in Medicare. Finally, it mandates document retention and provision requirements on providers and supplier that order and certify items and services for Medicare beneficiaries.

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