Round 2028 DME Remote Item Delivery: Who Can Furnish and Who Controls the Order

Round 2028 DME contract suppliers will furnish seven product categories through nationwide Remote Item Delivery contracts scheduled to start January 1, 2028. The change reaches beyond who wins a bid. It reaches the supplier taking over a patient’s recurring supplies, the pharmacy handing over the product and the billing department submitting the claim. If you work inside that healthcare supply chain, the important question is whether the order, the item delivered and the Medicare bill tell the same story.

When Does Round 2028 Start?

Round 2028 contracts and single payment amounts take effect January 1, 2028, under the Centers for Medicare & Medicaid Services’ October 2026 timeline. Registration opens December 1, 2026, and the bid window opens January 5, 2027. Registration closes February 1, the covered-document review date is February 8, and bidding closes March 10, 2027.

The agency targets late summer or early fall 2027 for announcing contract suppliers and payment amounts. Its announced category counts describe contracts it intends to award.

Which Medical Equipment and Supply Categories Are in Round 2028?

Round 2028 covers seven categories. The agency’s August 2026 contract-count announcement sets out the planned awards for each:

• Class II continuous glucose monitors and insulin pumps: ten contracts.
• Hydrophilic urinary catheters: ten contracts.
• Off-the-shelf back braces: three contracts.
• Off-the-shelf knee braces: four contracts.
• Off-the-shelf upper extremity braces: five contracts.
• Ostomy supplies: six contracts.
• Urological supplies: five contracts.

Hydrophilic catheters have their own competition, separate from urological supplies. Oxygen equipment, CPAP devices, wheelchairs and hospital beds are outside this round. The product category determines which competition a supplier enters and which items its contract obliges it to furnish.

The agency may add contracts to meet beneficiary demand or its small-supplier participation target.

Who Can Furnish a Nationwide RID Item?

The nationwide RID area covers every state, the territories and the District of Columbia. Under the Centers for Medicare & Medicaid Services’ program design, contract suppliers must furnish every item in their awarded category throughout that area. The contract requirement follows the covered Medicare Part B item wherever the patient lives.

Remote delivery also includes a local counter. A patient or caregiver may collect an item from a pharmacy or storefront owned by the contract supplier or its subcontractor. Home shipment and delivery remain options. Small suppliers have a network route under the competitive bidding rules, allowing businesses that cannot independently furnish all the items to participate together.

Medicare-enrolled Indian Health Service and tribally operated suppliers have an exemption from bidding and contract requirements when serving American Indian and Alaska Native beneficiaries. Supplier standards require applicable licenses, delivery records and separate product-specific accreditation for owned and subcontracted locations. The supplier remains responsible for delivery and proof of delivery.

Who Controls the Order and the Product?

When a physician specifies a brand or mode of delivery to avoid an adverse medical outcome, the contract supplier must furnish it, help find another contract supplier that can, or consult the physician about an alternative. If the physician rejects the alternative, the agency requires the supplier to furnish the prescribed item.

The contract also requires suppliers to make the same product range available to Medicare beneficiaries as to other customers. The agency publishes the brands each contract supplier furnishes and monitors compliance.

The transition makes the paperwork consequential. For beneficiaries moving from a non-contract supplier during the initial three months of the contract period, the new supplier has six months to obtain new orders if the old supplier does not transfer the medical-necessity documentation. This gives the incoming contract supplier time to replace missing orders; it does not extend the outgoing non-contract supplier’s right to furnish covered items. The grace period does not apply to purchases of off-the-shelf braces.

Inside the business, order versions, practitioner review, product selection and delivery records show how the prescription became a claim. A marketer may supply the patient lead, a telemedicine business may produce the order, and a different company may furnish and bill the item. Knowing who changed a product or quantity can connect decisions that otherwise sit in separate systems.

How Round 2028 Pricing and Contract Counts Work

Round 2028 uses lead-item bidding, with the lead item’s single payment amount set at the 75th percentile of winning bids. The lead item is the product with the highest nationwide Medicare allowed charges in its category before the competition. Its bid helps determine payment across the category.

The agency sets the planned contract count using the number of suppliers that furnished at least three percent of national allowed services for that lead item. It takes 125% of that supplier count, rounds to a whole number and applies a minimum of two contracts. Qualifying bidders are selected from the lowest composite bid upward. The agency also checks whether bids are feasible for furnishing every item in the category.

The agency can add qualified small suppliers toward a 30% participation target, or add suppliers to meet demand, without recalculating the payment amount.

The finalized pricing explanation says the percentile method pays more winners above their bid than below it and requires roughly 25% fewer contracts than the former calculation to keep total payments from rising. Part of the price change comes from narrowing the supplier pool.

What Changes for CGM and Insulin Pump Claims?

Under Round 2028, supplier claims for a CGM or insulin pump will use a monthly rental bundle covering the device, necessary supplies and accessories. Contract suppliers may bill up to three months of rental in advance.

The ongoing supply business is central to this change. Under the finalized rule, CGMs, insulin pumps and their necessary supplies furnished outside the competitive bidding program also move to a monthly rental bundle, with payments limited to the program’s established amounts.

Who Owns Durable Medical Equipment?

For the new CGM and insulin-pump rental arrangement, the contract supplier retains ownership. A beneficiary who already owns a device when contracts begin may keep using it until replacement is needed or the beneficiary chooses rental. Contract suppliers must furnish replacement supplies and accessories for those beneficiary-owned devices too.

The same supplier can therefore serve patients using rented devices and patients using equipment they already own. The device record, supply record and claim need to identify which arrangement the patient actually has.

Round 2028 Bid Bonds, Enrollment Bonds and Accreditation

A bid surety bond backs participation in the competition. The enrollment surety bond is a continuing condition tied to a supplier’s Medicare billing number, generally required at $50,000 per National Provider Identifier. They serve different jobs: the bid commitment and the continuing enrollment.

Records in Medicare’s enrollment system, PECOS, identify supplier locations. Applicable state licenses and product-specific accreditation belong with those locations. The agency also evaluates financial sustainability and requires a business credit report with a numerical score or rating.

The annual accreditation change requires surveys and reaccreditation at least every twelve months. Suppliers with a current three-year cycle issued before January 1, 2026, move to the annual cycle when that existing cycle expires. The survey checks quality standards. Medical necessity, the source of the order and the resulting bill still require their own scrutiny.

What Does Earlier Competitive Bidding Show About Access?

The history and patient-access evidence are covered in our overview of earlier DME competitive bidding.

What Are the Documentation Guidelines for Durable Medical Equipment?

Durable medical equipment documentation requirements connect the written order, supporting medical records and proof of delivery to the item billed. Intake staff see the original request. Product and shipping teams know what went out. Billing staff see the code, quantity and recurring charges. The useful comparison includes changes to orders, supplier ownership, subcontractor invoices and applicable refill-contact records.

For catheter and ostomy refills, the supplier must contact the patient and document an affirmative response before sending more supplies. Automatic shipments and contact records created afterward expose a gap between the refill file and what happened. An intake employee may see a completed refill record while the shipping log shows the package left before anyone contacted the patient.

Claims analysis can identify where to look. In the 2019 Osteo Relief Institutes settlements, the Justice Department said its investigation arose from analysis of Medicare claims data. The government alleged that clinics provided unnecessary custom knee braces. In a separate catheter audit, the Office of Inspector General identified a sharp increase in curved-tip catheter claims for female enrollees.

For someone inside a health care supplier, repeated mismatches and instructions to continue billing can explain how a false claim reached Medicare. When suppliers buy false orders and bill for unwanted equipment, patients and taxpayers bear the cost while honest suppliers compete for real business. A whistleblower case under the False Claims Act can pay 15% to 30% of what the government recovers.

When the Order and the Bill Tell Different Stories

If you know who changed an order, chose the product or kept the claims running, speak with our whistleblower experts about what happened inside the supplier. We build the case around those decisions and bring in durable medical equipment fraud whistleblower lawyers who understand supplier billing and recurring supply claims. We stay beside you from the first call through the case, with the expertise to follow both the orders and the money.