Suppliers that Choose Not to Grandfather - Round 1 Recompete (10-Day and 2-Day Notifications)

Grandfathering Provisions of the Medicare DMEPOS Competitive Bidding Program

Sample Letter to Beneficiary from Supplier that Chooses NOT to Grandfather CLEAN 508

Suppliers that Choose Not to Grandfather - Round 1 Recompete (10-Day and 2-Day Notifications)

OMB: 0938-1079

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Sample Letter to Beneficiary from Supplier that Chooses NOT to Grandfather
Our records show that our company, [insert supplier name], is currently furnishing you with
rented [insert name of equipment].
Starting July 1, 2013, there will be a new program called the Medicare Durable Medical
Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program to
help you save money when you get certain Medicare-covered medical equipment and supplies.
Under this program, people with Original Medicare in your area will almost always need to buy
or rent certain medical equipment and supplies from suppliers that contract directly with
Medicare to furnish these items. We won’t be a Medicare contract supplier under this new
program, so we won’t be providing [insert name of equipment] to people with Original
Medicare.
We will only continue to provide your [insert name of equipment] until [insert first
anniversary date after July 1, 2013]. After this date, you must get your equipment and related
accessories and supplies from a new Medicare contract supplier for [insert name of equipment].
We will contact you ten (10) business days before picking up your equipment to arrange for the
equipment to be picked up and new equipment to be delivered by your new Medicare contract
supplier. We will coordinate the pick up and the delivery of the equipment with your new
contract supplier to occur on the same day so there is no interruption in service. We will contact
you again two (2) business days before picking up your equipment to remind you of the
scheduled date and time.
Any Medicare contract supplier for [insert name of equipment] for your area is required to
furnish your [insert name of equipment]. You need to contact a Medicare contract supplier for
[insert name of equipment] as soon as possible to make arrangements for the Medicare contract
supplier to begin furnishing you with [insert name of equipment] beginning on [insert first
anniversary date after July 1, 2013].
To find a new Medicare contract supplier, visit www.medicare.gov/supplier/home.asp or call 1800-MEDICARE (1-800-633-4227) and have your ZIP code ready. TTY users should call 1-877486-2048.
If you have any questions, please contact us at [insert supplier phone number] or call 1-800MEDICARE (1-800-633-4227).


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