Medicare Competitive Bidding for Home Medical Equipment Frequently Asked Questions
What services does Providence Home Medical Equipment provide?
Providence Home Medical Equipment is a full-service durable medical equipment company providing services including oxygen, CPAP/BiPAP and supplies, diabetes meters and supplies, wheelchairs, hospital beds and accessories, enteral food and supplies.
What is Providence Home Medical Equipment’s service area?
Providence Home Medical Equipment has four locations in the greater Portland, Newberg, Salem, Hood River, and Vancouver, Wash. areas. Our service area is at least 50 miles surrounding each location.
Are there any other payors affected by Medicare’s decision?
No. Providence Home Medical Equipment continues to provide services for most other payors and Medicare patients outside of the Portland/Vancouver Competitive Bidding Area (CBA). The 2013 contracted payor list remains your guide to home medical equipment contracts.
Does Medicare’s decision affect Medicare Advantage programs like Providence Medicare or Regence MedAdvantage?
No. Providence continues to provide for Medicare Advantage plans such as Providence Medicare or Regence MedAdvantage.
How does this affect traditional Medicare patients currently receiving services from Providence Home Medical Equipment?
Providence Home Medical Equipment will be transitioning all existing traditional Medicare patients within the competitive bidding area to contracted suppliers except for Medicare capped oxygen patients (Oxygen patients who are on service between 36 and 60 months).
The transition will begin as early as May 2013 and be effective in July 2013. Providence Home Medical Equipment will work with its patients and their selected home medical equipment supplier(s) to ensure a smooth transition.
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.
When will Providence HME begin referring new patients/orders to Medicare contracted suppliers?
On May 15, 2013, Providence will begin referring new Medicare orders to Medicare contracted suppliers for Providence hospital discharges, The Oregon Clinic referrals, and orders from sleep labs. We will facilitate the hand-off of these referrals to a contracted supplier. Additional changes will be implemented mid-May for Providence Medical Group referrals, and all other orders.
How do I know if I live in a Competitive Bidding Area (CBA)?
CBAs are determined by ZIP code. Patients can determine if they live in a CBA by using the tool on the competitive bid website.
Who are the contracted traditional Medicare suppliers?
Medicare has published a full list of contracted suppliers by ZIP code and supply category.
How will patients be notified of the need to transition service to another supplier?
Providence Home Medical Equipment will follow the proper notification required by Medicare, which includes a written notification 30 days prior to transition, as well as a 10-day and two-day follow up notification to confirm. Equipment will not be picked up until we can coordinate with a contracted supplier for delivery of replacement equipment.
What do I do if I am a traditional Medicare patient, and I need repairs for equipment that I own?
After July 1, 2013, Providence Home Medical Equipment cannot perform billable repairs for traditional Medicare members outside of the warranty period. We can direct you to a Medicare Contracted Supplier for repairs.
What if a traditional Medicare patient would like to stay with Providence Home Medical Equipment and self-pay?
Medicare rules prevent a home medical equipment supplier from knowingly accepting self-payment from a Medicare beneficiary. Unfortunately, we cannot provide self-pay services for items that are covered by Medicare.
Why did Providence Home Medical Equipment decide to stop taking new traditional Medicare patients prior to July 1, 2013?
We believe it is in the best interest of the patient to avoid disruption of services when we are so close to July 1. However, we will not turn away any order if we cannot locate a willing contract supplier in a timely manner.
Will Providence Home Medical Equipment continue to provide products that are not in competitive bidding categories?
Most home medical equipment services are included in Medicare Competitive Bidding. We feel it is in the patient’s best interest to have home medical eqipment services come from contracted suppliers in order to provide continuity of care. Therefore, we will refer most orders to those suppliers.
Where do I refer Medicare patients for more information regarding competitive bidding?
Medicare has a website for patients, physicians and other interested parties.