42 CFR § 414.410 - Phased-in implementation of competitive bidding programs.
(1) In CY 2009, in Cincinnati - Middletown (Ohio, Kentucky and Indiana), Cleveland - Elyria - Mentor (Ohio), Charlotte - Gastonia - Concord (North Carolina and South Carolina), Dallas - Fort Worth - Arlington (Texas), Kansas City (Missouri and Kansas), Miami - Fort Lauderdale - Miami Beach (Florida), Orlando (Florida), Pittsburgh (Pennsylvania), and Riverside - San Bernardino - Ontario (California).
(2) In CY 2011, in an additional 91 MSAs (the additional 70 MSAs selected by CMS as of June 1, 2008, and the next 21 largest MSAs by total population based on 2009 population estimates, and not already phased in as of June 1, 2008). CMS may subdivide any of the 91 MSAs with a population of greater than 8,000,000 into separate CBAs, thereby resulting in more than 91 CBAs.
(i) Rural areas.
(ii) MSAs not selected under paragraphs (a)(1) or (a)(2) of this section with a population of less than 250,000.
(iii) An area with low population density within an MSA not selected under paragraphs (a)(1) or (a)(2) of this section.
(1) The total population of an MSA.
(4) An MSA's geographic location.
(c) Exclusions from a CBA. CMS may exclude from a CBA a rural area (as defined in § 412.64(b)(1)(ii)(C) of this subchapter), or an area with low population density based on one or more of the following factors -
(3) Low number of Medicare fee-for-service beneficiaries relative to similar geographic areas.
(d) Selection of additional CBAs after CY 2009.
(1) Beginning after CY 2009, CMS designates through program instructions or by other means additional CBAs based on CMS' determination that the implementation of a competitive bidding program in a particular area would be likely to result in significant savings to the Medicare program.
(2) Beginning after CY 2009, CMS may designate through program instructions or by other means a nationwide CBA or one or more regional CBAs for purposes of implementing competitive bidding programs for items that are furnished through the mail by nationwide or regional mail order contract suppliers.