Spending bill includes DME-related provisions

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Friday, February 9, 2018

WASHINGTON – Home infusion and O&P providers are the big winners with the passage of a government spending bill early this morning.

The bill, which passed the House 240 to 186 and the Senate 71 to 28, contained several DME-related provisions, in particular, one that would create a temporary transition payment for home infusion to address a payment gap created by a provision in the 21st Century Cures Act.

“The legislation will allow Medicare beneficiaries, specifically those with heart failure and immunodeficiency diseases, to receive critical life-saving infusion therapies in their own home,” said NHIA President and CEO Tyler Wilson. 

The Cures Act requires Medicare to pay for services associated with providing Part B home infusion drugs, but not until 2021. The temporary payment, as laid out in the Medicare Home Infusion Therapy Access Act of 2017, will become effective Jan. 1, 2019.

The government spending bill also contains a provision that recognizes the clinical notes of orthotists and prosthetists as part of a patient’s official medical record to determine medical necessity. The provision comes from the Medicare Orthotics and Prosthetics Improvement Act of 2017.

Also in the bill: a provision to remove the rental cap for speech-generating devices.