CMS defines durability

Thursday, July 14, 2011

WASHINGTON - How long should durable medical equipment last? Three years, according to CMS.

In a proposed rule published in the Federal Register July 8, CMS floats the idea of "a 3-year minimum lifetime standard for items to meet the durability criterion for DME." Currently, Medicare policy states only this: "An item is durable if it can withstand repeated use."

"Our initial reaction is we don't see a need for it," said Cara Bachenheimer, senior vice president of government relations for Invacare. "If an item isn't a supply or isn't disposable, it's clearly durable. This seems rather arbitrary."

CMS states in the rule that the Department of Commerce, as well as various dictionaries, encyclopedias and economics textbooks, use three years as a benchmark for durable goods.

Industry stakeholders aren't sure why CMS is looking to further define durable, but they suspect it has something to do with savings. If it's in writing that DME must last at least three years, then the agency may be able to save on repairs and replacements, they say.

"They're looking for savings in every nook and cranny," said Julie Piriano, director of rehab industry affairs for Pride Mobility Products.

Initially, there was confusion over whether CMS is seeking to change the reasonable useful lifetime of DME from five years to three years. But the rule states: "It is important to note that the 3-year minimum period of durability does not replace the RUL standard." 

"This proposed rule deals with coverage criteria," Bachenheimer said. "The RUL deals with payment criteria."

As is often the case with proposed rules, industry stakeholders say the devil is in the details. Of the impact, CMS states: "The revised regulation would provide clear guidance to CMS and other stakeholders for making consistent informal benefit category determinations and national coverage determinations for DME. It would assist manufacturers in designing and developing new medical equipment to have a better understanding of how long a period of time an item must be able to withstand repeated use to be considered DME for Medicare purposes."

"It would have an impact; we're just not sure what kind of impact yet," Piriano said.

CMS will accept comments on the rule until Aug. 30. To comment, go to The agency plans to respond in a final rule on Nov. 1.

Read the rule.