Medicare Competitive Bidding Changes for Home Medical Equipment
What is changing for traditional Medicare patients who need home medical equipment?
As you might be aware, traditional Medicare has made the decision to use only selected contracted suppliers–chosen through a competitive bidding process–for home medical equipment services in the Portland and Vancouver areas.
- Oxygen and supplies
- CPAP/BiPAP and supplies
- Hospital beds and accessories
- Wheelchairs and accessories
- Walkers and accessories
- Enteral equipment, food and supplies
As a result, only those selected contracted home medical equipment suppliers will be able to provide services for these individual product lines. Home medical equipment suppliers not contracted will not be able to provide new services. Unfortunately, Medicare did not choose Providence Home Services as a contracted supplier for any of the competitive bidding product lines.
I have a Medicare Advantage plan—does this change affect me?
This only affects traditional Medicare patients within the competitive bidding area. Providence will continue to provide services for all other contracted payors, including Providence Health Plans, Medicare Advantage Plans and Medicare patients outside the competitive bidding area.
Why wasn’t Providence Home Medical Equipment chosen as a supplier?
Providence Home Medical Equipment submitted a competitive bid, below current payment levels. Medicare ultimately selected a reimbursement level that averages 45 percent below current levels. This means Medicare did not choose Providence to be a contracted supplier.
What does this mean for Providence Home Medical Equipment patients in the Portland metro area?
After July 1, 2013, Providence Home Medical Equipment will not be able to provide services for new Medicare orders in the selected product categories within the Portland area and much of the Vancouver area.
What about patients in Hood River, Vancouver or Salem?
The competitive bidding area is defined by ZIP code. As a result, all of Hood River service area, most of Salem service area, and parts of Vancouver service area will remain under the current Medicare payment methodology.
Providence Home Medical Equipment will continue to take referrals and provide services for traditional Medicare members in areas not affected by competitive bidding.
Does Medicare’s decision affect other Providence Home Services ministries including Providence Home Health, Providence Hospice, and Providence Home Infusion?
No. This change does not affect any other Providence ministry, including home health, hospice, or home infusion services.
What’s next for Providence Home Medical Equipment?
In order to provide superior service to our existing patients, we have begun preparations for this transition:
- We will begin to limit new orders for affected services prior to July 1, 2013 in order to reduce future disruption to patients.
- We will be transitioning all existing traditional Medicare patients within the competitive bidding area to contracted suppliers. The transition will begin as early as May and will be effective in July. This transition will not affect Medicare capped oxygen patients (oxygen patients between 36 and 60 months).
Still have questions?
Read our Frequently Asked Questions or find detailed information and fact sheets on the topic of Competitive Bidding from the Centers for Medicaid and Medicare Services.