CMS pushes back face-to-face requirement

Friday, June 28, 2013

BALTIMORE – The HME industry got a small reprieve June 27 when CMS announced it would not enforce the new face-to-face requirement until Oct. 1.

The rule was slated to go into effect July 1, along with Round 2 of competitive bidding.

In a letter to Congress on June 27, the Office of Legislation at CMS stated:

“CMS is concerned that some may need additional time to establish operational protocols to comply with this new law. As such, CMS expects that during the next several months, suppliers and physicians who order certain DME items will continue to collaborate and establish internal processes to ensure compliance with the face-to-face requirement.”

CMS will also address industry questions concerning the requirement and will update information at

CMS issued its final rule on the face-to-face requirement in November 2012. The rule requires a face-to-face exam with a physician within 90 days for certain high-cost DME. With millions of beneficiaries starting to make the transition to new providers July 1 as part of competitive bidding, the industry predicted utter chaos.

Stakeholders have also criticized the minimal education CMS has offered to providers. A recent HME NewsPoll found that 68% of respondents didn’t have a firm grasp of the rule. It also found that a whopping 95% believe the requirement will significantly impact patient access.