Editor's Note

Competitive Bidding's Forever Pause

What's the situation with Round 2021 of competitive bidding and what does it mean for pharmacies serving DMEPOS beneficiaries?

• By David Kopf
• Apr 01, 2021

At the end of October, CMS announced that after originally taking bids for 16 product categories in the 130 competitive bid areas of Round 2021 of its competitive bidding program, it was only awarding contracts for the off-the-shelf back and knees braces categories. As for the 13 remaining categories, CMS announced it would not issue contracts because it “did not achieve expected savings.”

For DME pharmacies participating in DMEPOS, that means that given the last competitive bidding contracts expired on Dec. 31, 2018, and that the bidding program has since been dormant, they can continue to provide these 13 categories without contracts. That seems like an attractive prospect, but it means supplying those items at reimbursement rates that are essentially frozen at 2018 rates.

Will the HHS and CMS under the Biden Administration steer back toward competitive bidding? It’s clear that CMS realizes it has reached a bid floor. It also knows that it’s more expensive for suppliers to deliver care and products during COVID-19. If competitive bidding makes a return, the pieces on the board will need to be reset if CMS wants the game to be sustainable.

This article originally appeared in the DME Pharmacy April 2021 issue of HME Business.