CMS starts implementation process for Cures provision

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Tuesday, November 28, 2017

WASHINGTON – CMS wants state Medicaid programs to submit their DME fee schedules using a new spreadsheet to make sure they’re not paying too much for equipment, according to a notice in the Federal Register.

CMS says the spreadsheet will help the agency comply with a provision in the 21st Century Cures Act that requires it to cap Medicaid reimbursement for DME at Medicare reimbursement starting Jan. 1, 2018.

“We would require the minimal amount of information be collected from states to comply with this statute (at 8 hours per state per year),” the agency states in the notice. “More specifically, we would ask states to demonstrate compliance by filling in their DME fee schedules onto the new spreadsheet page with the relevant information—HCPCS code series A, K, and E only, that are relevant to this information collection of durable medical equipment.”

CMS is accepting comments on the new program through Jan. 29, 2018.

Industry stakeholders have been waiting for details on how CMS plans to comply with the provision in the Cures Act. The provision was included in the act as a “pay-for.”