Pivotal Bid Results for Round 2021 of the DMEPOS Competitive Bidding Program: Analysis & Commentary
By Mark J. Higley, Vice-President, Regulatory Affairs, VGM & Associates, Inc.
On January 15, CMS publicly shared the pivotal bid (“clearing price”) amounts for the 13 product categories that were withheld from the Round 2021 program.
As most are aware, 16 product categories were originally included in the program. Non-invasive ventilation was dropped from the competition earlier due to concerns relative to the public health emergency. Two categories – off the shelf knee and back braces – were included, and remain contracted in 127 CBAs for both categories (three CBAs have none) and in about a dozen CBAs only one of the two categories are contracted. The reason: “insufficient savings,” an authority the agency maintains in this (and all previous) bidding rounds to remove contracting procedures if administration costs are at a level where contracting savings to the entitlement program are insufficient.
To which brings me to the purpose of this document: the remaining 13 categories were removed from competition in all of the 130 CBAs for the identical justification....Click here to read more!