What is the Medicare Competitive Bidding Program?
Recent laws enacted by Congress, including the Affordable Care Act, require the Department of Health and Human Services (HHS) to implement a competitive bidding program for suppliers of wheelchairs and other durable medical equipment as a cost-savings measure under Medicare.
Under competitive bidding, Medicare only makes payments to a limited number of wheelchair suppliers that have been selected by HHS.
As a result, individuals living with spinal cord injury and paralysis are likely to have fewer suppliers to choose from for both purchase and repairs of wheelchairs and other durable medical equipment. The bid prices may also be too low to cover advanced or customized equipment.
Some people have been forced to give up their existing suppliers or must travel greater distances to access a supplier that has been selected by HHS.
The Reeve Foundation is concerned that the Medicare Competitive Bidding Program will result in reduced access to suppliers of wheelchairs and durable medical equipment for individuals living with spinal cord injury and paralysis.
A "Competitive Acquisition Ombudsman" (CAO) is available within the Centers for Medicare and Medicaid Services (CMS) to respond to inquiries and complaints made by suppliers and individuals regarding the application of the Competitive Bidding Program.
HHS announced that it would expand the competitive bidding program to accessories of complex rehabilitation technology starting in 2016.
Complex Rehabilitation Technology (CRT) includes unique and individually configured equipment, wheelchairs, positioning systems, and more. “Accessories” include all parts of the chair beyond the base, such as cushions and head rests.
This change runs contrary to Congressional intent of the Medicare Improvements to Patients and Providers Act of 2008, which exempted CRT from competitive bidding.
The Reeve Foundation worked with our mobility advocacy partners to educate Congress about this potentially damaging change. In December 2015, Congress passed a one year delay in the application of the competitive bidding prices to complex power chairs.
The cuts in payments for complex power chairs has only been delayed by one year, and cuts have taken affect for manual chairs. The Reeve Foundation will continue to advocate to permanently exempt both power and manual complex chairs from the competitive bidding program.
If you have been negatively impacted by the Competitive Bidding Program, or you have additional questions, you are encouraged to call 1-800-MEDICARE (1-800-633-4227).