CMS delivers another blow with new pricing

July 1 pricing factors in Round 2 re-compete pricing, making cuts even steeper
Thursday, June 23, 2016

WASHINGTON – CMS late this afternoon released new pricing for non-competitive bidding areas as of July 1, and in one fell swoop handed down cuts of anywhere from 10% for insulin pumps to 80% for TENS units compared to pricing in 2015.

Among 15 products highlighted in a CMS fact sheet, 11 show cuts of 50% or more, AAHomecare pointed out in a bulletin.

“It’s clear that these are cuts that will be devastating for providers and patients alike in these areas, and ultimately unsustainable for a healthcare infrastructure serving the needs of a growing senior population, as well as people with disabilities and chronic conditions who depend on HME,” the association stated.

CMS implemented a first round of cuts in non-bid areas, averaging about 25%, on Jan. 1.

The agency did, as stakeholders suspected it would, factor in new pricing for the Round 2 re-compete into the July 1 pricing, making the cuts even steeper.

The new pricing comes just as the industry was with one hand celebrating the Senate passing a bill that would delay this second round of cuts for one year and with the other hand decrying a sit-in in the House of Representatives over gun control that prevented a similar bill from passing there.

AAHomecare says there “may be a chance” to move forward after Congress returns from its July 4 recess, with a bill that would retroactively stop the July 1 pricing.

“We are also working with other parties in the Senate and in the administration to directly ask CMS to delay the cuts until legislation can be considered,” it stated.


Cannot imagine a more grim situation for our industry. It's funny I grew up in the industry with a boss that was fond of saying "If you take care of the patient, the business will take care of itself". Now I'm forced to lower our quality of service the customers are used to and just become another bad option for people. Ok time for a scotch now..