CBIC: Competitive Bidding Gap to Occur for Back & Knee Braces

• By Laurie Watanabe
• Jun 01, 2023

The Competitive Bidding Implementation Contractor (CBIC) is reminding HME suppliers about the upcoming temporary gap in Medicare’s competitive bidding program for off-the-shelf back braces and knee braces.

In a May announcement and the corresponding MLN Fact Sheet, the CBIC noted that the current competitive bidding contract expires Dec. 31, 2023, creating a gap starting on Jan. 1, 2024.

“The Centers for Medicare & Medicaid Services plans to conduct bidding for the next round of the DMEPOS CBP (competitive bidding program) after going through notice and comment rulemaking to further strengthen the DMEPOS CBP,” the CBIC said.

Before bidding starts for the next competitive bidding round, the CBIC said it will complete the formal public notice and comment rulemaking process; implement changes to establish sustainable prices, save money for Medicare beneficiaries and tax payers; and limit Medicare fraud, waste and abuse while ensuring patient access to “quality items and services.”

During the gap period, the CBIC said, “Medicare-enrolled DMEPOS suppliers may furnish DMEPOS items and services to patients” according to these payment rules:

— Adjusted fees in former competitive bidding areas (CBAs) are based on 100 percent of the single payment amount for the CBA increased by the projected percentage change in the Consumer Price Index for All Urban Consumers (CPI-U) from January 2023 to January 2024, and…

— Adjusted fees in non-CBAs are based on fully adjusted rates per the applicable methodology under 42 CFR 414.210(g)