The DME billing Florida suppliers handle today is not yet affected by competitive bidding, and a good deal of published material suggests otherwise. Sorting out what is actually happening matters, because the preparation window is open now and the decisions made during it will set reimbursement for years.
Here is the accurate position. Medicare’s competitive bidding program for durable medical equipment has been in a temporary gap period since January 1, 2024, when the last remaining contracts expired. The round now underway began in 2026 with the rule and the bidder education program, runs through bidding across 2026 and 2027, and produces contracts and pricing that take effect no earlier than January 1, 2028. Nothing in the program changes what Florida suppliers are paid this year, and everything about what they are paid in 2028 is being decided during it.
The Rule Is In Effect Even Though Pricing Is Not
CMS published its final rule updating the program in December 2025, and the rule itself took effect January 1, 2026. That gap between an effective rule and effective pricing is what confuses people.
The rule sets the structure. Bidding activity runs across 2026 and 2027, with product categories, lead items, and contract counts announced during that period. Contracts and payment amounts begin no earlier than the start of 2028, followed by a six month transition period for beneficiaries to move to contract suppliers.
The Round Splits Into Two Different Payment Geographies
This is the point most worth getting right, because the round does not apply one geographic model across every product.
Items commonly shipped or delivered directly to beneficiaries fall into a nationwide program described as remote item delivery. Contract suppliers in that program furnish covered items to beneficiaries regardless of location, so those categories carry no service area boundary at all.
For a Florida supplier, that changes the competitive question entirely in those categories. A regional supplier is no longer competing for a Florida service area. Contract counts are national and small, and the winners serve the whole country.
Categories Outside That Program Still Run on Competitive Bidding Areas
Product categories not included in the nationwide program continue to operate through competitive bidding areas, and those are the zones Florida suppliers need to watch.
CMS was slated to announce the non-nationwide product categories during 2026, along with the lead item for each category and the number of contracts to be awarded. The areas a supplier can bid into, and the number of contracts available in each, are what determine where a Florida supplier can realistically compete.
Bidders need a surety bond for each competitive bidding area they bid into, which makes the number of areas a supplier pursues a direct cost decision rather than an open-ended one.
The Categories & the Contract Counts
The categories identified for the nationwide program cover continuous glucose monitors and insulin infusion pumps, urological supplies, ostomy supplies, and off-the-shelf braces.
CMS has indicated a limited number of contracts per category, with roughly ten combined contracts for glucose monitors and insulin pumps, eight separate contracts each for urological and ostomy supplies, and six separate contracts each for off-the-shelf upper extremity and knee braces, with final numbers subject to claims data. The count for each category is derived from the number of suppliers furnishing a meaningful share of national volume for the lead item.
Product categories outside the nationwide program were slated for announcement during 2026, along with lead items and contract numbers.
Mechanics That Decide If a Bid Survives
Several procedural changes deserve attention from anyone considering a bid.
Bidding, documentation, and communication now run through a single system rather than the two separate platforms used previously. CMS allows one opportunity of ten business days to correct bond deficiencies, and reviews for missing documents now happen at the close of the bid window rather than at earlier checkpoints.
For braces, urological supplies, and ostomy supplies, bids are capped at the average 2026 fee schedule amounts. That cap tells suppliers where the ceiling sits well before bidding opens, which makes current-year cost analysis directly relevant to a bid two years out.
Suppliers running the numbers on participation, often with support from billing partners who track program mechanics such as AAA Medical Billing, generally start with cost per unit against the applicable cap rather than with the bidding process itself. A category that cannot be served profitably at the cap is not worth bidding regardless of how the process runs.
Florida Has Its Own Enrollment Problem Right Now
Separate from Medicare, Florida acted on Medicaid DME enrollment in March 2026 with a temporary moratorium on enrolling new Medicaid providers for durable medical equipment. The state was the first to follow Medicare’s lead on this.
The immediate effect falls on suppliers planning expansion. A moratorium period is not the time to build a growth plan around new Medicaid enrollment, and suppliers with applications in progress should confirm their status rather than assume the pipeline is moving.
Existing enrolled suppliers are not the target, and revalidation deadlines matter more than usual when reenrollment is not readily available.
What Preparation Actually Looks Like
The temptation is either to ignore a 2028 date or to overreact to a program that has not started. Neither serves a supplier well.
Begin by mapping your product mix against the two structures, since the share of revenue sitting in nationwide categories is exposed differently from the share sitting in categories that will be bid by area. A Florida supplier concentrated in categories outside those groups faces a different question than one built on glucose monitors or ostomy supplies.
Calculate your true cost per unit in exposed categories, including acquisition, delivery, documentation, and billing labor. The cap for several categories is already known in relation to current fee schedule amounts, which means you can model viability now.
Watch for the category, lead item, and competitive bidding area announcements during 2026 and 2027, and follow the bidder education program rather than waiting for the bid window. The areas available and the contract counts in each are what tell a Florida supplier where it can compete, and they arrive before the bid window rather than with it. Suppliers that treat education sessions as optional consistently discover requirements late.
Confirm your accreditation and surety bond position early. These are not items to address during a bid window.
The Decision Is Participation, Not Preparation
For many suppliers the eventual question is not how to win a contract but how to operate without one. Non-contract suppliers can continue furnishing items outside contracted categories, and some will restructure around categories left out of the program.
That decision needs cost data and product mix analysis, both of which take time to assemble. The runway to 2028 looks long from here and closes faster than it appears, particularly for suppliers who wait for the bid window to begin thinking about it.
