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Competitive Bidding is Here: What is It & What Does It Mean to Me?

California Health Advocates > Fraud & Abuse > Competitive Bidding is Here: What is It & What Does It Mean to Me?

Posted by Karen Fletcher on May 17, 2013

Paula Holden, one of our SMP Liaisons, wrote this article below on the Durable Medical Equipment, Prosthetics, Orthotics and Supplies Competitive Bidding Program, and what the beginning of Round 2 on July 1, 2013 means to beneficiaries. It’s short, sweet and informative….

Well, “competitive bidding” has been tested by Medicare in other areas across the nation for some time now, and it is saving us money. That’s a good thing. By controlling the Durable Medical Equipment (DME) providers through a price bidding process, the costs to you & me have gone down. This program is rolling out in various areas in California and the country, starting July 1, 2013.

What this means for you is, if you are using any Durable Medical Equipment, Prosthetics, Orthotics, or Supplies (DMEPOS), your prices are better controlled, but your supplier may change. If your medical equipment comes from out of the area, your DMEPOS providers had to apply, be approved by Medicare, and bid and agree to the approved pricing. Not all suppliers wanted to do this. Why? Well some were, shall we say, more fair than others. Some could be a bit scammy! This program helps to eliminate over-charging for items; billing for items never received; signing you up & then disappearing; changing their names etc. With this new competitive bidding program, Medicare has more control over who can supply items and what they can reasonably charge you.

So, don’t be surprised if your current diabetic mail-order supplier tells you to buy elsewhere. In fact, many of the mail-order suppliers have opted out of this bidding process. You might have to get your diabetic supplies from a local pharmacy. The good news is that prices will be better managed and more affordable, plus some of the bad guys will go away. You can find a list of suppliers on Medicare.gov or call your local Health Insurance Counseling and Advocacy Program (HICAP) for assistance at 800-434-0222.

Remember not to let scammers fool you by offering a fake, on-the-side deal or supplies from Canada or Mexico, or pretending to be from Medicare. Medicare will not call you. If you get a call that doesn’t seem right, call your Senior Medicare Patrol at 855-613-7080.

For more info on fraud, see our section on Medicare fraud. See Medicare.gov for more info on the competitive bidding program.

 

Filed Under: Fraud & Abuse

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About Karen Fletcher

Our blogger Karen J. Fletcher is CHA's publications consultant. She provides technical expertise, writing and research on Medicare, health disparities and other health care issues. With a Masters in Public Health from UC Berkeley, she serves in health advocacy as a trainer and consultant. See her current articles.

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