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The landscape of mail-order diabetes supplies changed drastically on Jan 1, 2011, when Medicare introduced what is known as the “competitive bidding program” in several areas across the United States.
The program, formally entitled the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program, changes the way Medicare pays for mail-order diabetic supplies in nine major regions across the United States. The program means Medicare will refund only customers who purchase their mail-order diabetes supplies from an Approved Medicare Contract Supplier, a supplier certified as a “competitive bid winner.”
The new program spans nine major urban centers and the immediately surrounding areas including: Pittsburgh, Cincinnati-Middletown, Kansas City, Dallas-Fort Worth, Charlotte, Miami-Fort Lauderdale, Orlando, Cleveland, and Riverside, California. Patients living in any of these regions who have Original Medicare, and who have had their mail-order diabetes supplies paid for until now, will likely be affected by the introduction of the competitive bidding program. To have Medicare pay for mail-order diabetes supplies, patients must ensure they buy through an approved Medicare contract supplier.
Competitive Bidding helps Medicare ensure only trusted and reputable suppliers provide product and services to the public. Patients who are currently getting their mail-order diabetes supplies from a company that isn't a competitive bid winner will risk paying full-price for the items. Medicare recommends that patients using a diabetes supplier that isn't a bid winner change their provider as soon as possible, to ensure their supplies will continue to be paid for by their Original Medicare coverage.
The competitive bidding program affects only the stores that deliver, or offer the option to deliver, their diabetic supplies through mail order. Storefront locations like pharmacies will remain unaffected by the change, and Medicare will continue to pay for supplies purchased at any store. Mail-order supplies cover any supplies that are ordered via the Internet, by phone, email or mail, and delivered to the patients address by a postal service.
Medicare says the patient will not be paying more for supplies because of the introduction of this program. The patient can't be charged more than the 20% coinsurance that is standard in Original Medicare.
A fact often overlooked is that the program affects any patient who travels from outside the regions covered into a region included in the competitive bidding program. Any patient who holidays in one of the locations, such as the popular Miami and Fort Lauderdale region, will need to order their diabetes supplies from an approved Medicare contract supplier in order to get their refund.
Medicare ran a bidding program in 2010 and selected 356 suppliers, based on their meeting Medicare's quality and financial standards. The Centers for Medicare and Medicaid Services, which run Medicare in the U.S., released the list of 356 suppliers who won contracts to provide refundable supplies in November last year. They distributed information about the program widely to ensure beneficiaries were prepared for the change.