CMS updates fee schedule, AAH pledges to push back

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Wednesday, May 3, 2017

WASHINGTON – CMS has delivered “a slap in the face” to the HME industry with its updated fee schedule for rural and non-competitive bidding areas, AAHomecare says.

The agency released the updated fee schedule to meet a provision in the Cures Act that requires the agency to retroactively delay a second round of reimbursement cuts that went into affect in those areas on July 1, 2016, until Jan. 1, 2017, allowing HME providers to recoup six months worth of payments.

The problem, AAHomecare says: CMS recalculated the rates based on the July 1, 2016, fee schedule instead of the Jan. 1, 2016, fee schedule, resulting in rates that are lower than they should be.

“CMS’s decision to recalculate these rates based on the July 1 fee schedule are a slap in the face to the HME community, as well as to members of Congress who worked hard to include relief for our industry into the Cures bill,” said Tom Ryan, president and CEO of AAHomecare. “Individuals on Capitol Hill that we’ve spoken with are perplexed that CMS has defied clear congressional intent to essentially extend the Jan. 1 rates for the second half of 2016.”

For oxygen concentrators, for example, the January 2016 rate in New England was $140.56; the original July 2016 rate was $77.72; and the updated July 2016 rate is $125.30. The updated July 2016 rate represents a 10.9% reduction from the January 2016 rate.

AAHomecare says it is “more determined than ever” to advocate for better reimbursement for HME providers.

“This development lends additional urgency to our industry’s efforts to provider longer term relief for rural and non-bid providers, and I expect these rates will help spur the HME community into heartfelt advocacy on this issue,” Ryan said.