Release of Single Payment Amounts May Be Delayed

According to information released by VGM, the release by CMS of the “single-payment amounts,” the amount CMS will pay for DME items in the Round 1 competitive bidding areas.  VGM attributes the likely delay to an article in Inside Health Policy.

Below is the verbatin story from VGM with a link to the article:

Competitive Bidding: Bid Rates Unlikely to Be Released Today
Because of a June 10 Inside Health Policy report, many DME providers and industry leaders expected CMS to announce the “winning” bids for the DME competitive bidding program today.  The report noted that CMS was to announce the single-payment amounts on June 25 and claim savings for the program before lawmakers leave for the July 4 recess.   However, according to AAHomecare’s Walt Gorski and the CBIC, it is unlikely that CMS will make this announcement until later this month. 

To view the Inside Health Policy report, click here.

As the announcement of the “winning” bid rates, looms, bidders should expect the following in the coming days and weeks:

1. Announcement of “winning” bid rates (“single payment amounts”) sometime between June 28 and 30.

2. Potential contract providers will see an e-mail come through either shortly before or following the announcement notifying them to expect a package to arrive.

3. Bidding  providers will see one of three types of letters from CMS approximately three to five days following the announcement.  The letters will be as follows:

a. Contract offer:  Providers may receive a letter stating that they are being offered a contract.  The letter will contain the terms of the contract and response instructions.

b. Qualified but no offer:  Providers may receive a letter stating that they met all bidder eligibility requirements, but submitted a composite bid above the pivotal bid threshold.  Providers will be advised that, should contracts be rejected by those offered, they may be offered a contract at a later date.

c. Did not qualify:  Providers may receive a letter stating that they did not qualify to be offered a contract.  This may mean one of several things, including but not limited to:  failure to meet financial standards, lack of sufficient financial documentation, lapsed accreditation or surety bond, or lack of proper state licensure.

4. Providers who are offered contracts will be given between 10 and 30 days to respond by either:

a. Signing the contract and accepting/following proper procedure, or

b. Rejecting the contract.

5. In late July and August, CMS will evaluate the gaps in supply left by contract rejections and offer contracts to providers who received the second type of letter (see above).

6. In September, CMS will announce the list of all contract providers.

7. Contracts will go effective January 1, 2011.

For any questions, please contact VGM National Competitive Bidding Services at NCBHelp@vgm.com.