CMS Seeks to Add 21 MSAs to Competitive Bidding's Round 2

As part of Medicare's proposed 2011 physician fee schedule, the Centers for Medicare & Medicaid Services is seeking to add 21 metropolitan statistical areas (MSAs) to the 70 areas already announced for Round 2 of the program.

The 21 proposed MSAs are described as follows, in descending order of population totals:

  • Philadephia/Camden/Wilmington (Pennsylvania, New Jersey, Delaware, Maryland)
  • Washington/Arlington/Alexandria (District of Columbia, Virginia, Maryland, West Virginia)
  • Boston/Cambridge/Quincy (Massachusetts, New Hampshire)
  • Phoenix/Mesa/Scottsdale (Arizona)
  • Seattle/Tacoma/Bellevue (Washington)
  • St. Louis (Missouri, Illinois)
  • Baltimore/Towson (Maryland)
  • Portland/Vancouver/Beaverton (Oregon, Washington)
  • Providence/New Bedford/Fall River (Rhode Island, Massachusetts)
  • Buffalo/Niagara Falls (New York)
  • Rochester (New York)
  • Tucson (Arizona)
  • Honolulu (Hawaii)
  • Albany/Schenectady/Troy (New York)
  • Worcester (Massachusetts)
  • Oxnard/Thousand Oaks/Ventura (California)
  • Springfield (Massachusetts)
  • Bradenton/Sarasota/Venice (Florida)
  • Poughkeepsie/Newburgh/Middletown (New York)
  • Stockton (California)
  • Boise City/Nampa (Idaho)

In addition, CMS is seeking to divide the New York, Chicago and Los Angeles area MSAs into smaller sections.

Said CMS in the proposed physician fee schedule, "For round 2, we are proposing to subdivide MSAs of 8 million or more in population.... We have identified three MSAs which, based on the 2009 estimate from the Census Bureau data, could be subdivided. We are proposing to divide these MSAs into separate CBAs (competitive bidding areas) because we believe this approach would create more manageable CBAs for contract suppliers to serve and allow more small suppliers to be considered for participation in the program."

In determining how to divide the largest MSAs, CMS said it considered the geographic size of the MSA and location of the counties within compared to neighboring counties; the driving distances north-south and east-west within each MSA; the total population and the total number of Medicare beneficiaries using DME that's part of the competitive bidding program; and interstate highway infrastructures of the MSAs, among other criteria.

Bidding for round 2 is scheduled to get underway in spring 2011. CMS will accept comments to this proposed rule for 60 days after it's published in the Federal Register - which is expected to happen on July 13, according to a bulletin sent out by the American Association for Homecare on June 29.

To comment on this proposed rule, go to and follow the instructions for submitting a comment. You can also mail written comments to Centers for Medicare & Medicaid Services, Department of Health & Human Services, Attention: CMS-1503-P, P.O. Box 8013, Baltimore, MD 21244-8013. Written comments need to be received by CMS before the end of the comment period.

About the Author

Laurie Watanabe is the editor of Mobility Management. She can be reached at

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