Grandfathering

Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program – Contracting Forms (CMS-10744)

CMS-10744.Sample Letter - Chooses NOT to Grandfather

Grandfathering

OMB: 0938-1408

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Sample Letter to Beneficiary from Supplier that Chooses NOT to Grandfather
Our records show our company, [insert supplier name], is currently furnishing you with rented
[insert name of equipment].
Since January 1, 2011, Medicare has implemented a competitive bidding program for certain durable
medical equipment, prosthetics, orthotics, and supplies (DMEPOS). On January 1, 2021, Medicare
will start new competitive bidding contracts with DMEPOS suppliers in your area. 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 program, so we won’t be providing
[insert name of equipment] to people with Original Medicare in your area starting January 1, 2021.
We will only continue to provide your [insert name of equipment] until [insert first anniversary
date after January 1, 2021]. 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 current 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 new 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 new Medicare contract supplier for [insert
name of equipment] as soon as possible to make arrangements for the new Medicare contract supplier
to begin furnishing you with [insert name of equipment] beginning on [insert first anniversary date
after January 1, 2017].
To find a new Medicare contract supplier, visit www.medicare.gov/supplier or call 1-800MEDICARE (1-800-633-4227) and have your ZIP code ready. TTY users should call 1-877-486-2048.
If you have any questions, please contact us at [insert supplier phone number] or call 1-800MEDICARE (1-800-633-4227).


File Typeapplication/pdf
File TitleSample Letter - Chooses NOT to Grandfather 4.15.20
SubjectSample Letter - Chooses NOT to Grandfather 4.15.20
AuthorArthur Yon
File Modified2020-11-04
File Created2020-04-15

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