Stakeholders question authority to bundle

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Thursday, March 23, 2017

WASHINGTON – CMS does not have the authority to implement bundled bidding programs for CPAP or other HME, because it would jeopardize patient access to specific equipment, say industry stakeholders.

Bundling a CPAP device, consumable items, maintenance and service into a single monthly payment will cause disruption for suppliers and will provide an incentive to furnish inferior products and provide a lower quality of care to compensate for shrinking margins, said AAHomecare in its weekly newsletter.

Additionally, “it could substantially increase co-payments and out-of-pocket expenses for beneficiaries,” said Larissa D’Andrea, government affairs director for ResMed. “Plus, layering untested bundled payments on top of expanded competitive bidding program rates could compound existing access challenges caused by these other cuts.”

AAHomecare and industry groups like AdvaMed, the CQRC and The VGM Group are developing a unified response to Medicare’s proposal to bundle payment for CPAP in future rounds of competitive bidding. They plan to outline their response a forthcoming letter to CMS.

CMS on Jan. 31 announced it had added 10 new competitive bidding areas for the CPAP category. In five of those CBAs, payment for CPAP devices, related accessories, and services will be made on a bundled, non-capped monthly rental basis, while payment in the other five CBAs will be made on a capped monthly rental basis like all other existing CBAs.

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