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CMS delivers another blow with new pricing

CMS delivers another blow with new pricing July 1 pricing factors in Round 2 re-compete pricing, making cuts even steeper

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.

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