Part B Drug Allowables for First Quarter 2009

The Centers for Medicare & Medicaid Services (CMS) has made available the Medicare Part B Drug and Biological Average Sales Price (ASP) Payment Amounts for January 1, 2009 to March 31, 2009, on the CMS website. The files are located in the "Downloads" section of this web page.

Accreditation Guidelines for Pharmacy – READ THE FINE PRINT!

The National Supplier Clearinghouse has provided the following information for pharmacists NOT supplying DMEPOS...

CMS has deemed that suppliers providing drugs and pharmaceuticals only are not required to be accredited to obtain/maintain Medicare billing privileges. If suppliers bill for DMEPOS outside of pharmaceuticals, including products to administer drugs or pharmaceuticals, accreditation will be required to maintain Medicare billing privileges.

Pharmacy suppliers must update their file with the National Supplier Clearinghouse (NSC) by choosing "Pharmacy" as the supplier type in section 2B, and selecting "Drugs/Pharmaceuticals" only in section 2C of the CMS-855S enrollment form. All other products/services must be removed to assume the accreditation exemption.

Suppliers found to be in violation of this rule by billing for other products or services will be subject to appropriate actions up to and including revocation.

Test Your Staff's DMEPOS Billing Knowledge

If you have been billing Medicare for years or are just starting out, stop by the DME MAC A website today and Test Your DMEPOS Billing Knowledge!

The Test Your Knowledge section is available at: http://www.medicarenhic.com/dme/dme_quiz_form.shtml

New quizzes will be released regularly, so check back often.

Keep an Eye Out for Seniors Experiencing the Holiday Blues

While the holiday season is a festive time for many, it can cause depression for seniors who've lost loved ones or are having health or financial problems.

For some seniors, this despondency can lead to suicide, according to the American Geriatrics Society, which noted that the 2004 suicide rate for Americans over the age of 65 was 14 per 100,000. Considering the current economic crisis, I expect much of the same in 2009.

Many older people don't realize when they're depressed. Seniors need to understand that depression is a medical illness that can be treated and managed. “Toughing it out” may have devastating effects. Pharmacists have an expanded role to play during these stressful times.
It’s hard at times to pick our heads up from the computer screen, especially during flu season, but a pharmacist's job is more than “ putting pills in a bottle.”

A review of the medication profile alerts you if the patient is in treatment already. Ask the patient how they are doing. If you’re an independent pharmacist, your patients already are comfortable talking with you.

Their responses might indicate a need for an antidepressant dosage adjustment, or that a visit to the appropriate health professional is warranted.

And, what about your own Blues? Well, you already know the answer. Patients come first as you have done from the day you opened the door. I know, I did it myself for 25 years.

Be well and Happy Holidays to you all!

Health and Human Services Secretary Blagojevich?

It is alleged that Illinois Gov. Rod Blagojevich, in a charge related to the appointment of a senator to replace Barack Obama, sought appointment for himself as Secretary of Health and Human Services, or a lucrative job with a union, in exchange for appointing a union-preferred candidate.

Regardless of your affiliation, you have GOT to love politics!

But What About the Dollar Menu?

A study found that people given packaged meals were more successful at losing weight than were participants who chose their own portion sizes. Cutting down on portion sizes is the best way to combat the creeping obesity epidemic. Pharmacists can assist patients, especially those with diabetes, in managing weight issues by providing easy ways to measure portions correctly. For example, your fist is equivalent to 1 cup or 8 ounces. Tips such as this endear patients to your pharmacy. Find more and distinguish yourself from the competition.

Make Space for This Product

According to a nationwide survey by the American Association of Diabetes Educators (AADE), only 25 percent of people with diabetes know their HbA1c level, and less than 20 percent have their HbA1c tested regularly. FDA approved, over-the-counter Hemoglobin A1c (HbA1c) tests should have prominent shelf space in your pharmacy's diabetes care department.

Medtrade Attendance Drops 20%

The 29th Annual Medtrade Conference and Expo was held in late October at the Georgia World Congress Center in Atlanta. Medtrade officials this week reported attendance of nearly 10,500 at this year’s show, a dip of almost 20 percent from last year. Officials said the attendance dip reflects the industry and economic conditions, and general trends from all trade shows.

Nonetheless, the “baby boomers” are not getting any younger. They, and their caregivers, will need your services to stay well and in the homes and communities they cherish. So, stay efficient and recognize this economic downturn for the inevitable opportunity it will be.

A Little Light Reading

There are two great articles in the November issue of America 's Pharmacist magazine related to DMEPOS accreditation and competitive bidding.

One is "Fact Versus Fiction" by Harry A. Lattanzio, R.Ph., of PRS Pharmacy Services (page 34). In this one, Harry sets the record straight on accreditation requirements.

The other article is Jeffrey S. Baird's "Rx Law" column on the future of competitive bidding (page 51).

These articles are also accessible to NCPA members online at www.americaspharmacist.net.

Pre-diabetes on the Rise

A CDC analysis of data on 24,000 U.S. adults found that more than 25% of Americans have pre-diabetes, but only 4% were aware of their condition. Researchers said more awareness about pre-diabetes could help people make healthier lifestyle choices and reduce their risk of developing diabetes.

It’s all about drug cost containment and preventative care! Are you doing your part?

Doom and Gloom from Weems: Medicaid Spending Spirals Out of Control

The Centers for Medicare and Medicaid Services (CMS) warned policymakers late Friday that Medicaid spending is projected to grow much faster than the economy over the next 10 years. With expenditures headed toward $5 trillion over the decade, agency officials said, now is the time to rein in costs. “This is an urgent reminder that the current spending path of Medicaid is unsustainable,” said Kerry Weems, CMS acting administrator.

Pharmacists are not responsible for the spiraling costs, but it is imperative we all do our part, whenever possible, to contain drug costs.

Obesity Doubling Rate of Diabetes Cases

The nation's obesity epidemic is exacting a heavy toll: The rate of new diabetes cases nearly doubled in the United States in the past 10 years, the government said Thursday. The highest rates were in the South, according to the first state-by-state review of new diagnoses. The worst was in West Virginia, where about 13 in 1,000 adults were diagnosed with the disease in 2005-07. The lowest was in Minnesota, where the rate was 5 in 1,000.

Serving patients with diabetes can be rewarding and profitable. Sharpen you skills and provide products and services your customers cannot get in the mailbox.

What's a RAC?

The Centers for Medicare & Medicaid Services (CMS) has announced aggressive new steps to find and prevent waste, fraud and abuse in Medicare. CMS is working closer with beneficiaries and providers; consolidating its fraud detection efforts; strengthening its oversight of medical equipment suppliers and home health agencies; and launching the national recovery audit contractor (RAC) program.

The new RAC program contractors will look at billing trends and patterns across Medicare. They will focus on companies and individuals whose billings for Medicare services are higher than the majority of providers and suppliers in the community. CMS is also shifting its traditional approach to fighting fraud by working directly with beneficiaries and ensuring they received the durable medical equipment or home health services for which Medicare was billed and that the items or services were medically necessary.

Big brother is watching!

CMS Calls for PAOC Nominees

As a result of MIPPA 2008, CMS has decided to bring “fresh blood” to the PAOC. The current PAOC group is no more. An alternative would have been to extend the term of the original members. I, for one, would have liked to see this through. The committee has invested five years trying to assure beneficiaries have convenient access to DMEPOS through the implementation of competitive bidding.

It makes you wonder why CMS would “retire” the current PAOC group and replace them with those of similar background. Do you think they did not like what they were hearing?

Part B Drug Prices - Hot Off the Press

The Centers for Medicare & Medicaid Services (CMS) has made available the Medicare Part B Drug and Biological Average Sales Price (ASP) Payment Amounts for October 1, 2008 to December 31, 2008 on the CMS website at http://www.cms.hhs.gov/McrPartBDrugAvgSalesPrice/01a_2008aspfiles.asp#TopOfPage. The files are located in the "Downloads" section of this web page.

CMS: 2009 Part B Premium to Remain the Same

The standard Medicare Part B monthly premium will be $96.40 in 2009, the same as the Part B premium for 2008, according to CMS. This is the first year since 2000 that there was no increase in the standard premium over the prior year. What happens after the elction is anybody’s guess!

CMS: It May Take 9 Months to Obtain Facility Accreditation

The accreditation process may take up to nine months to complete for an enrolled DMEPOS supplier that submits a complete application to the Accreditation Organizations (AOs), and has no deficiencies to correct post onsite-survey. Therefore, all enrolled DMEPOS suppliers will need to submit a complete accreditation application to the accreditation organizations (AOs) by January 31, 2009. This is to ensure that the DMEPOS supplier will receive an accreditation decision (provided that they meet the all the accreditation requirements) by the accreditation deadline of September 30, 2009. If you are going to seek accreditation, the time to act is NOW!

CMS Says Apply for DMEPOS Accreditation by January 31, 2009...or Else

At a September 3 Special Open Door Forum to address DMEPOS supplier exemptions for some practitioners—and NO pharmacists are NOT exempt—CMS announced that they have been assured that accreditating organizations have the capacity to accredit all suppliers, including pharmacists, by the September 30, 2009, deadline, BUT only if they apply BEFORE January 31, 2009.

Many retail buying groups and wholesalers have negotiated agreements to lower accreditation costs for their members and customers. Give them a call to find out further information about those deals!

If you apply AFTER January 31, 2009 you will be gambling with your Medicare Part B billing number.

Are you feeling lucky?...If not, apply for DMEPOS accreditation today. The clock is ticking.

Girlfriend, Can I Have One of Those?

I guess it’s not only seniors that sometimes face the tough choice of buying food versus medicine.

In a recent survey, it was discovered that borrowing and sharing of prescription medications is common practice among more than one-third of women of reproductive age. Women of reproductive age (18-44 years) are more likely to report this practice (36.5%) than are other aged women (19.5%). Allergy medications (43.8%) and pain medications (42.6%) were the types of drugs most commonly borrowed or shared by this group of women.

A letter to the editor from Mr. Kuhn

CMS Deputy Administrator Herb Kuhn writes in a letter to the editor, published Aug. 5 in the Baltimore Sun:

“Congress just axed a promising program to replace government-mandated pricing with competitive bidding” for DME. “Continued congressional inertia will only impose crushing obligations on our children and grandchildren and undermine our country's economic viability in a global economy.”

Just 1%

According to government figures, Medicare loses approximately $70 billion annually to fraud. Of that, approximately $700 million--less than 1 percent--is from fraudulent DME claims.

What DOES NSC Do Anyway?

National Supplier Clearinghouse (NSC) responsibilities include issuing and recommending revocations of Medicare Part B billing privileges for suppliers; and ensuring that only accredited, qualified suppliers are enrolled in the Medicare program. The NSC also is required to establish and maintain programs to prevent and detect fraud.

There…now you know!

DMEPOS Competitive Bidding Delayed; Accreditation Deadline Remains in Effect

The Medicare Improvements for Patients and Providers Act of 2008 was enacted on July 15, 2008. This new law delayed the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. As a result of this delay, the accreditation deadlines related only to the second round of the program have been cancelled.

However, the deadline of September 30, 2009, that was previously established for all DMEPOS suppliers to be able to bill Medicare Part B and retain a Medicare Part B billing number is still in effect.

Pharmacy Provisions Go to President

The Senate Wednesday invoked cloture and then passed by voice vote and sent to the President H.R.6331, legislation that includes suspension of the Medicare DME competitive bidding program, a 14-day reimbursement cycle for Medicare Part D claims, and a further delay in AMP-based Medicaid generic drug reimbursement cuts.

The cloture vote was 69 to 30. Sixty votes were required to move to final passage of the measure, whose main focus has been on preventing a 10.6 percent cut in Medicare payments to physicians. Two previous attempts failed in the Senate last month. The House passed the bill 355-59.

More details will be coming soon on what you can do ensure that the three vital community pharmacy provisions become law in the face of a predicted presidential veto.

Stay tuned!

DuoNeb Local Coverage Determination Delayed

The nebulizers local coverage determination, effective for dates of service on or after July 1, 2008, is being revised. The implementation of least costly alternative to the FDA-approved unit dose combination of albuterol sulfate and ipratropium bromide (DuoNeb - J7620) is delayed and will become effective for claims with dates of service on or after November 1, 2008. Suppliers should become familiar with the new Nebulizers Policy prior to its effective date to minimize effects on their billing process.

Why Delay Competitive Bidding?

In a recent statement, Senate Finance Committee Chairman Max Baucus (D-Mont.) proved he "gets it" when it comes to delaying the start of Medicare competitive bidding.

“Durable medical equipment can give seniors the freedom to live at home, and so it’s important to maintain a reliable system in Medicare to provide these vital items," Baucus said. "I am supportive of competitive bidding as a means of reducing cost, but that cannot be accomplished at the expense of low quality and inconsistent care. The competitive bidding program for durable medical equipment should stay on hold until it’s certain that seniors will get the products they need in a way that works for them.”

It Seems Like Everybody is Suing CMS

Citing faulty implementation of Medicare’s competitive bidding program for durable medical equipment, prosthetics, and supplies (DMEPOS), the American Association for Homecare filed a federal lawsuit on June 9 seeking to stop the controversial bidding program.

The program affects medical equipment and services used by Medicare beneficiaries in the home including oxygen therapy, hospital beds, and power wheelchairs.

The complaint names as defendants U.S. Department of Health and Human Services (HHS) Secretary Michael Leavitt and Centers for Medicare and Medicaid Services (CMS) Acting Administrator Kerry Weems.

Tip Sheets for Grandfathering DMEPOS Suppliers and Referral Agents

Recently, CMS posted two new tip sheets related to competitive bidding, one on grandfathering and another for referral agents. Both tip sheets can be found on the CMS competitive bidding website at www.cms.hhs.gov/DMEPOScompetitivebid. Click on the "Provider Educational Products and Resources" tab and scroll down to the “Downloads” section.

325 Suppliers to Serve How Many Beneficiaries?

The Centers for Medicare & Medicaid Services (CMS) released the names of the 325 suppliers that have signed contracts with Medicare to provide certain medical equipment and supplies to beneficiaries in 10 communities across the U.S.

Find out the names of winning bidders in your Metropolitan Statistical Area.

Who Won in Round One?

Based on bids submitted by these suppliers, beneficiaries and Medicare will see prices, on average, 26 percent lower than Medicare currently pays for the same items. CMS received bids from 1,005 suppliers. There were just under 6,200 bids for one or more product categories in competitive bidding areas (CBAs) where the new program is being implemented. CMS offered contracts to 23 percent of suppliers that submitted bids. These suppliers were in the winning price range and met quality and financial standards and disclosure requirements. Sixty-one percent of the bids submitted were priced higher than the winning range, and just over half of these high-priced submissions were disqualified because they failed to meet other bid requirements. The remaining 16 percent of bids would have been in the winning range had they not been disqualified.

Medicare Announces Winning Suppliers for Round I; Extends Accreditation Deadline for Round II

The Centers for Medicare & Medicaid Services (CMS) released the names of the 325 suppliers that have signed contracts with Medicare to provide certain medical equipment and supplies to beneficiaries in 10 communities across the U.S. The new competitive bidding program goes into effect on July 1, 2008.

CMS also announced that it is extending the deadline for suppliers in the 70 second round metropolitan statistical areas (MSAs) to become accredited. CMS is extending the deadline because a significant number of suppliers in those communities have not yet applied for accreditation.

Suppliers must be accredited or have applied for accreditation by July 21, 2008, (formerly May 14, 2008), and the final accreditation deadline for the second round of competitive bidding is now January 14, 2009, a change from the October 31, 2008 deadline.

To read the entire CMS Press release issued Monday, please go here: http://www.cms.hhs.gov/apps/media/press_releases.asp

Stark Seeks to Block 'Flawed and Lousy' Competitive Bidding Program

Calling the program “somewhere between flawed and lousy,” House Ways and Means Health Subcommittee Chairman Fortney “Pete” Stark (D-Calif.), said he was unsure if repeal legislation could pass this year. Round I of the program is set to take effect July 1 in 10 MSAs. However, he added he would work with the industry to try to block competitive bidding, despite the costs of ending the program.

Competitive Bid Final Jeopardy - What is 'that shows your usefulness as a witness?'

What Ways and Means Committee Chairman Pete Stark (D-CA) said when Acting CMS Commissioner Weems responded that he saw nothing that he would change about the DMEPOS Competitive Bidding Program.

Here’s the Math - 1,005 Bidders Round One, 630 Disqualified

Competitive bidding numbers gleaned from CMS officials at a briefing for House of Representatives staff ricocheted around the country last week. While much of the data was confusing, one thing was clear: Nearly 63 percent of the bids in Round One were disqualified.

CMS revealed that of the 1,005 unique bidders in Round One, 630 were disqualified due to insufficient applications.

Initially, CMS had expected more than 28,000 bidders across the 10 product categories and 10 MSAs in Round One.

Accreditation Required for Nebulizer, Enteral Sales; but NOT Part B Drugs

In a recent conference call, CMS clarified that a pharmacy must be accredited if it supplies nebulizers (i.e., DMEPOS) for Part B drugs, but not if it supplies only Part B drugs and no DME. Thus, if a customer obtains Part B drugs from a pharmacy, but obtains the nebulizer elsewhere, the pharmacy does not need to be accredited.

However, CMS emphasized that enteral nutrients, equipment, and supplies are considered DMEPOS for purposes of the Competitive Bidding Program, so a pharmacy supplying these items requires accreditation.

Why It’s So Hard! Why It’s So Important to Independents!

The next time someone asks you why being an NCPA member is important, or why supporting NCPAPAC or the LDF is critical to your business margins, or why it is so hard to get Congress to make our legislation a priority in the face of competing interests, you can cite the info in this article:

• Health care interests spend more on federal lobbying ($445 million) than any other sector of the economy ($2.8 B total in 2007).
• In terms of specific organizations or companies, the number three spender was PhRMA (tied with AMA at $22.1 million). Number one was the U.S. Chamber of Commerce, which paid its in-house and outside lobbyists $53 million.

CMS Releases Revised CMS-855 Medicare Enrollment Applications

Over the last year, CMS has received numerous comments and suggestions regarding the proposed revisions to the Medicare enrollment applications. CMS reviewed the comments and adopted many of the suggested revisions. Also, CMS incorporated a number of enhancements and changes to clarify the enrollment process and to reduce the burden imposed on the provider and supplier communities. Make sure your DMEPOS department understands the changes to avoid costly approval delays.

For more information, click here.

But, How Many Small Suppliers Were Pharmacists?

In announcing the first round of competitive bidding winners, CMS SAYS it ensured that small suppliers had the opportunity to participate in the competitive bidding program.

More than 6,300 bids were received from hundreds of suppliers. Sixty-four percent of winning bidders are "small" suppliers. How many pharmacists were winning bidders? I don’t know, but I’m going to do my best to find out!

Medicare Says Bidding Will Save Average of 26% for Some DMEPOS

To view the Medicare Press Release, please click: http://www.cms.hhs.gov/apps/media/press_releases.asp

Stealing Minds

An estimated 5.2 million Americans have Alzheimer's disease, and it could rob one of eight Baby Boomers of their mental capacities, according to a report released Tuesday by the Alzheimer's Association.

I’m told by my physician that forgetting what I was supposed to do when I get to the bottom of the steps is NOT Alzheimer’s. But, I still don't like it! Try not to take life too seriously my friends!

'Movin on Up' and 0.0023% for NCPA

A recent survey found that most pharmacists' salaries exceed $100,000. The average annual base salary was $107,403 in 2007, compared with $94,927 in 2006. It costs less than one quarter of one percent (0.0023 percent) of your yearly salary to have our collective voices heard through NCPA on Capitol Hill. In our business, we RARELY get deals like this one.

Wondering about the return on investment? How much did you save because NCPA fought to keep diabetes testing supplies out of DMEPOS competitive bidding? How much money stays in your pocket this year because of NCPA-initiated AMP injunctive relief.

At 0.0023 percent, NCPA membership is a real bargain my friends. Join NCPA today!

Are YOU Using Your NPI?

On March 1, 2008, Medicare claims submitted by physicians and other practitioners, laboratories, ambulance company suppliers, DMEPOS suppliers and others that bill Medicare are required to include the new National Provider Identifier (NPI).

All 837P and CMS-1500 claims MUST have an NPI or NPI/legacy pair in the required primary provider fields. Failure to include an NPI will cause rejection of the claim!

Spending on Boomers 'Top of Mind' at CMS

Hospital spending will double to more than $1.3 trillion by 2017, making up roughly 30 percent of all healthcare spending and representing the largest portion, by far, of any provider group, according to the CMS.

Do You Believe It? I’m Not Convinced

CMS’ actuaries estimate that DME competitive bidding will produce the following savings for the Medicare trust funds beginning in FY 2009 ($ in millions):
2009 -- $ 640
2010 -- $1,030
2011 -- $1,100
2012 -- $1,190
2013 -- $1,290

Congress Proposes Increase for DME Surety Bond

A Senate bill introduced last week would impose a $500,000 surety bond requirement on providers of durable medical equipment (DME) to Medicare beneficiaries.

The bill, S.2603, the “Medicare Fraud Prevention Act of 2008,” would increase the $50,000 surety bond requirement by a factor of 10. The bill would also increase civil and criminal fines for Medicare fraud and abuse.

The bill is sponsored by Sens. Mel Martinez (R-Fla.), John Cornyn (R-Texas), Norm Coleman (R-Minn.), Lamar Alexander (R-Tenn.), David Vitter (R-La.), and Jim DeMint (R-S.C.).

Stay tuned...

21 NSC Part B Supplier Standards AND Now 5 More!

• Locations must be open a minimum of 30 hours a week. The CMS is also seeking comments on whether to establish a minimum square footage requirement.
• Suppliers must have comprehensive liability insurance of $300,000 per incident.
• Cell phones, beepers and answering machines can't be used as the primary business phone during operating hours.
• Suppliers can't use "a contract individual or entity to provide a licensed service," requiring instead that personnel be on staff.
• Suppliers can't share a location with other Medicare suppliers, such as physicians or home health agencies.
  

Sage Advice From CMS's Bastinelli

“Accreditation is not just about writing a check and waiting for a survey. It’s up to providers to stay on top of the process. Do not sit back and wait. Do not assume that because you have sent a check in that you will (make) the deadlines. Go to your organization and they will tell you what your timeline is." -- CMS's Sandra Bastinelli, January 22 DME Accreditation 101 teleconference

DMEPOS Subcontracts and Accreditation Confusion

While it is technically correct that you do not have to be accredited to become a DMEPOS subcontract supplier, supplying bid items like walkers, for a winning bidder, the point is now moot.

If you sell just one box of diabetes testing strips, EVEN if you are a subcontracted supplier for walkers, you MUST obtain accreditation by September 30, 2009. Now, if you just want to sell walkers as a subcontracted supplier, and you are going to give up your Part B billing number and your diabetes supply business, then, you do NOT need to become accredited.

Still confused…probably. Bottom line, you must obtain accreditation prior to September 30, 2009 to maintain your Medicare billing number. Get started today!

Urgent NPI Update: Test Your Medicare Part B Claims Now!

After Medicare providers have submitted claims containing both NPIs and legacy identifiers and those claims have been paid, Medicare urges these providers to send a small batch of claims NOW with only the NPI in the primary provider fields. If the results are positive, begin increasing the number of claims in the batch.

Note: All current and past CMS NPI communications are available by clicking "CMS Communications" in the left column of the www.cms.hhs.gov/NationalProvIdentStand CMS webpage.

DMEPOS Accreditation 101: CMS Schedules Calls

DMEPOS Accreditation 101
Tuesday, January 22
1 p.m. - 2:30 p.m. Eastern Time

This audio conference is the first in a series of four designed to provide guidance to DMEPOS suppliers regarding accreditation. Topics to be discussed will be compliance with the DMEPOS Quality Standards, the accreditation process and providing ample time to answer questions from the suppliers. To download the call presentation, that will be posted in the days just prior to the call, visit http://www.cms.hhs.gov/MedicareProviderSupEnroll/.

A Quote to Remember

“I cannot stress enough the importance for all Part B DMEPOS suppliers to apply for accreditation early, and not wait until September 30, 2009. Suppliers considering participating in the second phase of the competitive bidding program should apply for accreditation immediately.” -- CMS Acting Administrator Kerry Weems (1/8/08)

CMS Announces Plans for Second Phase of Competitive Bidding

The Centers for Medicare & Medicaid Services (CMS) Tuesday announced 70 new areas across the nation will be part of the second phase of the durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) competitive bidding program. Ten areas currently participate in the program.

CMS expects to begin pre-bidding activities of the second round, such as announcing the specific zip codes that constitute the CBAs, specific items in each product category, and bidder education and registration for user IDs and passwords, in the spring of 2008. The bidding period is expected to run 60 days and is planned to begin in the summer of 2008. A more detailed timeline will be provided as the pre-bidding activities begin.

Suppliers must also meet quality standards established by CMS and be accredited by one of 10 organizations chosen by Medicare. The final deadline for all suppliers to obtain an initial accreditation is September 30, 2009. However, suppliers that want to participate in the second phase of the competitive bidding program will have to be accredited well in advance of that deadline to be awarded a contract with CMS.

“I cannot stress enough the importance for all Part B DMEPOS suppliers to apply for accreditation early, and not wait until September 30, 2009,” said CMS Acting Administrator Kerry Weems. “Suppliers considering participating in the second phase of the competitive bidding program should apply for accreditation immediately.”

The competitive bidding program also includes special considerations for small suppliers, and options for beneficiaries in the competitive bidding areas (CBAs) who have existing rental agreements with suppliers that are not chosen as winning bidders in the competition.

For more information on the competitive bidding program and accreditation requirements, visit www.pharmacistelink.com/medicaredme.

Additional information on the DMEPOS competitive bidding program is available at the following websites: http://www.cms.hhs.gov/CompetitiveAcqforDMEPOS/ and
http://www.medicare.gov/Supplier/Static/About/DMEPOS.asp.

Don’t Be Left Out in the Cold Without a Medicare Part B DMEPOS Billing Number

Accreditors continue to reiterate their warnings that providers need to allow time for the accreditation and survey processes. This time…I BELIEVE THEM. The process can take from several months to a year, depending on the pharmacy's resources and the DMEPOS services provided. You MUST realize that if everyone waits until the last minute, some companies will be left in the cold — without a Medicare billing number. Don’t let that be YOU!