Since January 1, 2019, there was a temporary gap for purchasing durable medical equipment (DME) in the Competitive Bidding Program. This program allowed DME suppliers to sell Medicare-approved products. Centers for Medicare and Medicaid Services (CMS) believe the gap may last until December 31, 2020.
How it worked
Previously, DME suppliers submitted a bid to Medicare for selected products. Evaluated bids were based on the supplier’s eligibility, financial stability, and bid price. Bids with the best price and met Medicare’s specific criteria were awarded contracts. Contracts meant that suppliers agreed to accept ALL assignment on claims for bid items.
The issue with the competitive bidding process prior was that only a few suppliers had bids. This inundated companies with DME orders that could not keep up. Beneficiaries had to wait before certain products were available to them. Some beneficiaries opt to purchase their DME out-of-pocket because their need was too great.
What will happen
With the temporary end of the competitive bidding process, a monopoly was eliminated on DME suppliers in the area. Thus, giving beneficiaries more options to choose where they purchased their DME from.
Without the competitive bidding process, companies can now make their own prices without limitations or caps. Beneficiaries are now responsible to shop around to find the best prices for their DME.
If you are looking to purchase a DME, here are some tips.
- Make sure the supplier is participating with Medicare
- If you have a Medicare Advantage plan, make sure you call your insurance and follow protocol on obtaining a DME
- Shop around, make sure you get the best price for the DME you are seeking
To find out if Medicare covers the supply or item you need or to find a DME supplier in Hawaii, call our Hawaii SHIP Helpline at 808.586.7299. Or contact us on this website and a trained volunteer counselor will get back with you shortly.