Medicare’s new Durable Medical Equipment rules

Starting July 1st, 2013, the greater Saint Louis area is now part of Medicare’s new competitive bidding program for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS).

This program should help lower the cost that Medicare pays for supplies like oxygen, CPAP machines, diabetic testing supplies, and much more.

What does this program do?
This program requires suppliers of Medical equipment to submit blind bids on Medicare covered equipment rather than paying a higher inflated price. Medicare will then use these lower priced bids to set costs on what it will pay which will help the Original Medicare program save money over time.

How will this program affect me?
If you do not currently use any equipment, than you will not see any change at all. If you currently rent, own, or need Durable Medical Equipment, you may see your current provider discontinue their services, requiring you to find a new supplier. It is important to note that if you are renting certain medical equipment or receiving oxygen or oxygen equipment that is paid on a monthly basis, you may be able to stay with your current supplier even it that supplier is not a contract supplier. Suppliers that are not Medicare contract suppliers can choose to become “grandfathered” suppliers. A “grandfathered” supplier may continue to rent equipment to you if you were renting it when the program starts. This rule applies only to oxygen and oxygen equipment.

If you already own medical equipment, you can use any Medicare-approved supplier for repairs.

For simplicity, if you find that your current provider of DME will not be part of Medicare after July 1st, 2013 I would strongly suggest you find different participating supplier. You can see a list of approved suppliers here:

What things are covered by Medicare (DMEPOS)
Here is a list of some common items:
-Diabetic testing supplies (Lancets, Testing Strips, Syringes)
-Breathing assistance devices (CPAP Machines and Masks, Oxygen tanks, Oxygen machines)
-Hospital Beds and Equipment
-Walkers and Wheelchairs

This is a step in the right direction for Medicare as it has often been criticized for paying too much for equipment. Hopefully it provides meaningful savings and further solidifies the Medicare program.

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