CMS publishes 2005 fee schedule

Sunday, November 21, 2004

November 22, 2004

ALEXANDRIA, Va. -  CMS wrote the FEHBP price cuts into the 2005 fee schedule published last week, setting in stone percentage reductions called for in the MMA.
The cuts aren’t quite as steep as the FEHBP reductions outlined in the OIG report Congress used as a foundation for the changes. For example, while the OIG found that FEHBP plans typically paid 22% less for nebulizers, CMS has cut reimbursement for nebulizers by an average of 15.6%.
That moderation, according to a ‘Washington Update’ Invacare published on its Web site, may be a result of political pressure.
“Dave Hobson, R-Ohio, Harold Ford, D –Tenn., and the other 110 co-sponsors of H.R. 4491 (a bill to repeal all these cuts) probably influenced CMS to be more moderate,” the update reported.
CMS plans to announce the oxygen reduction in mid-December. At an Open Door meeting in September, CMS Health Insurance Specialist Joel Kaiser noted plans to cut stationary oxygen by 11% and portable oxygen by 7%.
Otherwise CMS has cut reimbursement on semi-electric hospital beds (E0260) by an average of 13%, pressure mattresses (E0277) by 5.6%, lancets (A4259) by 3%, test strips (A4253) by 2.3%, power chairs (K0011) by 2.6% and manual chairs (K0001) by 3%. Except for these reductions (and a 3.3% boost for items classified as class III devices by the FDA), all other reimbursements remain the same.
Although the reductions have been published, AAHomecare is not ruling out congressional action to repeal the cuts.
“We urge Members of Congress to co-sponsor the Hobson-Ford bill, H.R. 4491, which would repeal these cuts,” Kay Cox, president and CEO of AAHomecare said in a prepared statement.  “At the same time, AAHomecare is working continuously with CMS and the Office of Inspector General to ensure that oxygen reimbursements are fair and accurate.”
One hundred thirteen members of the House of Representatives have co-sponsored H.R. 4491.