Round 2028 Competitive Bidding: What Suppliers Need Now

Medicare's competitive bidding program has been dormant since January 1, 2024, when the last Round 2021 contracts for off-the-shelf back and knee braces expired. Round 2028 restarts it with a structure suppliers have not seen before: a single nationwide remote item delivery (RID) competitive bidding area that covers every state, the District of Columbia and the territories, and seven product categories bid at the same time. Contracts are scheduled to start January 1, 2028.

For a supplier that ships CGM supplies, catheters, ostomy supplies or off-the-shelf braces, the practical deadline is not 2028. It is the close of the bid window, because that is the date by which CMS checks licenses, accreditation and enrollment in PECOS. Everything below comes from the Competitive Bidding Implementation Contractor (CBIC) website, CMS's official source for bidders, and the federal rules it cites.

What is on the Round 2028 timeline?

On October 7, 2026, CMS replaced its "late fall 2026" target with specific dates. To give bidders more time, registration and bidding now straddle the new year. The CBIC timeline, updated October 7, 2026, lists:

• December 1, 2026: bidder registration opens (user IDs and passwords for Connexion, the program's secure portal).
• January 5, 2027: the bid window opens.
• February 1, 2027: registration closes.
• February 8, 2027: covered document review date for financial documents.
• March 10, 2027: the bid window closes.
• Late summer or early fall 2027: CMS announces contract suppliers and single payment amounts.
• January 1, 2028: contracts and single payment amounts take effect, and a six-month grace period begins for contract suppliers to obtain written orders for patients switching to them.

CMS labels these as target dates, so watch the CBIC site for changes. Registration closes before the bid window does, which means a supplier that has not registered by February 1, 2027 cannot bid at all.

Which products are being bid?

The seven product categories, each with a lead item and a bid limit, are Class II continuous glucose monitors and insulin pumps; hydrophilic urinary catheters; ostomy supplies; off-the-shelf back braces; off-the-shelf knee braces; off-the-shelf upper extremity braces; and urological supplies (which no longer include hydrophilic catheters). CMS has also published how many contracts it expects to award in each: ten for CGMs and insulin pumps, ten for hydrophilic catheters, six for ostomy supplies, five for urological supplies, five for upper extremity braces, four for knee braces and three for back braces. It may add contracts to meet its small supplier target or beneficiary demand. Our post on the seven Round 2028 product categories covers the lead items, bid limits and category quirks.

Which requirements must be met by the close of the bid window?

CBIC's Bidder Eligibility Requirements fact sheet lists the conditions. Most are binary: meet them by March 10, 2027 (the current target) or the bid is not eligible for a contract.

1. A current CMS-855S enrollment, reflected in PECOS. PECOS must show every state and product the supplier furnishes or plans to furnish if awarded a contract.
2. Every required state and territory license, current and in PECOS. CMS verifies licenses through PECOS for each location (PTAN) on the bid. See every state license in PECOS by the close of the bid window.
3. Accreditation for the lead item and every non-lead item in each category bid, from a CMS-approved accrediting organization. CBIC is explicit that accreditation exemptions do not apply to competitive bidding, and that all pharmacies must be accredited to be eligible.
4. A $100,000 bid surety bond for the nationwide RID area, from a surety on the Treasury's list of certified companies, uploaded in Connexion. The amount was raised from $50,000 by the FY 2027 Inpatient Rehabilitation Facility final rule (CMS-1845-F, 91 FR 48982), effective October 1, 2026. One bond covers all of a bidder's RID bids. It is forfeited if the bidder is offered a contract with a composite bid at or below the median and declines it.
5. A business credit report with a numerical score or rating, dated no earlier than 90 calendar days before the bid window opens, plus the other financial documents in the Request for Bids instructions.
6. A bona fide bid. CBIC can ask a bidder to justify a lead item bid with invoices, price lists or written quotes, and disqualifies the bid if the support is missing.

The bid surety bond is not the $50,000 enrollment bond a supplier already carries under 42 CFR 424.57(d); CBIC says so in bold. They are separate instruments with separate purposes.

Why is state licensing the item most likely to sink a bid?

A nationwide area means a nationwide licensing footprint. CBIC's Licensure for Bidders fact sheet says a bidder "must be properly licensed for each State, the District of Columbia (D.C.), and any U.S. Territory" where it would furnish the items, and that licenses must be "current and non-expired" in PECOS by the close of the bid window and kept that way through the contract.

Two points soften this. The locations on a bid are judged together, so if a state requires a license, at least one location on the bid must hold it, and no more than one is needed. And you do not need to be licensed everywhere before you submit the bid; you need the licenses in PECOS by the close of the window. Small suppliers that cannot cover every state alone may bid as a network (see networks for small suppliers).

What does not soften it is the lead time. A state license has to be applied for, issued, then reported to the enrollment contractor and shown in PECOS. Some states inspect first. Alabama requires an out-of-state provider to keep a licensed physical location in Alabama. CMS's own FAQ warns that exemptions are narrow: Colorado exempts suppliers in Medicare's National Mail Order Program, but CMS says that exemption does not carry over to the Round 2028 nationwide RID program because the program name differs. CMS says it will publish a centralized licensure resource on the CBIC site before registration opens.

How does CMS pick winners and set prices?

Each bidder submits one amount per category, for the lead item, and that amount is treated as a composite bid for every item in the category. For Round 2028, CMS counts the suppliers that furnished at least three percent of national use of the lead item, multiplies by 1.25 and rounds, with a floor of two contracts. Qualified bidders are ranked from lowest composite bid up until that number is reached. The single payment amount for the lead item is the 75th percentile of the winning bids, and non-lead items are priced by ratio from it (42 CFR 414.414 and 414.416). CMS aims for at least 30 percent of contract suppliers to be small suppliers, those with $3.5 million or less in annual gross revenue, and can offer extra contracts to reach that target without changing the payment amounts.

Do suppliers without a contract keep billing for these items?

For most of these categories, they lose Medicare Part B payment for the items in the area. Because the area is nationwide, that means everywhere. CBIC's FAQs say suppliers without contracts cannot keep furnishing Class II CGM supplies, ostomy supplies, urological supplies or hydrophilic catheters to existing patients after contracts start. A non-contract supplier renting a Class II CGM or insulin pump at the start may elect to be a grandfathered supplier for those rentals. The six-month period that begins January 1, 2028 is a grace period for contract suppliers to collect written orders, not a period in which non-contract suppliers may keep billing.

There are limited exceptions for physicians, treating practitioners, therapists and hospitals furnishing certain items to their own patients (42 CFR 414.404), but CBIC says those exceptions do not apply to CGMs, CGM supplies, ostomy, tracheostomy or urological supplies.

Where do new suppliers stand after the 2026 moratorium?

CMS's six-month moratorium on enrolling new medical supply companies took effect February 27, 2026 and, according to a CMS notice posted on the competitive bidding site, expired August 27, 2026. The enrollment contractors are again accepting initial applications, and CMS urged prospective bidders to submit completed applications as soon as possible so they can be processed before bidding. A brand-new supplier still has to be accredited before it applies, pass high-risk screening and a site visit, and then hold every license in PECOS by the close of the window. That is a lot of sequential steps for the time left. Our post on the 2026 moratorium covers who it reached.

What should a supplier do this month?

• Pull your PECOS record for every location you would bid and list the states and product categories it shows.
• Map the states that require a license for the products you would bid, using the enrollment contractors' DMEPOS licensure database and its Notes section, and then the state's own law. Our state DME license requirements pages show what we have verified.
• Confirm that your accreditation names every item in the categories you plan to bid, including non-lead items.
• Line up the bid surety bond with your own surety agent once you decide to bid, and order the business credit report so its date falls inside the 90-day window.
• Register in Connexion between December 1, 2026 and February 1, 2027.

How can we help before the window closes?

We work on eligibility, not on the bid itself. Our DMEPOS Readiness Review ($149, credited toward a package) maps the states you ship to against the products you would bid and checks your PECOS record and accreditation scope. The Remote Delivery Licensing Package covers 10 states for $4,995, the Nationwide Licensing Package is $9,995, and single states are $699 ($899 for California, Florida, Georgia and Alabama). We prepare each license application and every attachment; your owner or officer signs it and pays the state, and we then prepare the 855S change of information so the license shows in PECOS. We do not sell surety bonds, we do not set bid prices, and no one can promise a contract. What we can do is make sure a missing license is not the reason a bid fails. Start with the DMEPOS enrollment hub.