CMS Medicare Competitive Bidding Program

What is Competitive Bidding?

Effective 1/1/2021, the Centers for Medicare & Medicaid Services (CMS) has contracted with certain DME suppliers who have met specific requirements to be the sole suppliers for certain OTS Knee and OTS Spine braces.  This is called the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program.

The DMEPOS Competitive Bidding Program was mandated by Congress through the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA). The statute requires that Medicare replace the current fee schedule payment methodology for selected Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) items with a competitive bidding process. The intent of the Act was to improve the effectiveness of the Medicare methodology for setting DMEPOS payment amounts, which would reduce beneficiary out-of-pocket expenses and save the Medicare program money while ensuring beneficiary access to quality items and services.