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Tag: Final Rule


News

CMS finalizes reimbursement relief in rural areas

December 21, 2021HME News Staff

WASHINGTON – CMS has published the DMEPOS Final Rule, making permanent the 50/50 blended reimbursement rates in rural areas but failing to provide relief in other areas.  For contiguous, non-rural areas, CMS says it will be paying suppliers 100% of the adjusted fee schedule rates using information from the competitive bidding program. For former bid areas, it says it will be paying the single payment amounts established during the program, plus an inflation adjustment factor on an annual...

CMS, DMEPOS, Final Rule, Reimbursement


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Industry readies to press forward on relief

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Industry readies to press forward on relief

December 10, 2021Theresa Flaherty, Managing Editor

WASHINGTON - With PAYGO-related Medicare cuts behind them, industry stakeholders are re-focusing on the DMEPOS final rule, lining up a new champion in Congress to lead reimbursement relief efforts.  On Thursday, the Senate approved legislation to prevent across-the-board, 4% PAYGO-related cuts to Medicare reimbursement from taking effect in 2022.  “It’s a large victory that resulted from a consortium of efforts from across the health care sector,” said Tom Ryan,...

Final Rule, Home Medical Equipment (HME), SPA


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Reimbursement relief: Stakeholders play all angles

July 9, 2021Theresa Flaherty, Managing Editor

WASHINGTON – Industry stakeholders say Congress is “definitely getting back to work,” after a long spring, during which there was little movement on HME issues.  Stakeholders have been meeting with industry champion Rep. Cathy McMorris Rodgers, R-Wash., to discuss legislative language for competitive bidding relief, line up a co-sponsor and identify possible vehicles for the fall, they said.  “We’ve had Hill visits, face-to-face meetings with members...

Competitive Bidding, DMEPOS, Final Rule, Legislative update


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Stakeholders push for rule’s release

March 1, 2021HME News Staff

WASHINGTON – The Council for Quality Respiratory Care has partnered with AAHomecare and the VGM Group to send a one-page letter to CMS urging the agency to finalize the DMEPOS final rule as quickly as possible.  A proposed rule published in October outlined the agency’s plans to make permanent the 50-50 blended reimbursement rates in rural areas.  “In light of the pandemic, it is more important than ever that the Medicare...

AAHomecare, DMEPOS, Final Rule, Medicare, Reimbursement, VGM Group


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News

CMS modernizes Stark Law

November 23, 2020HME News Staff

WASHINGTON - CMS has finalized a number of changes to the Stark Law, including new permanent exemptions for value-based arrangements, in a 627-page final rule set to be published in the Federal Register on Dec. 2. The exemptions will allow physicians and other health care providers to design and enter into value-based arrangements without fear that legitimate activities to coordinate and improve the quality of care for patients and lower costs would violate the physician self-referral law,...

Anti-Kickback Statute, Change, Final Rule, Stark Law


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In brief: CMS publishes final rule, Rotech taps $50M for acquisitions

November 1, 2019HME News Staff

WASHINGTON - CMS on Thursday afternoon released an ESRD final rule that implements a permanent home infusion therapy benefit in 2021 and establishes a methodology for establishing fee schedules for new DMEPOS items. CMS published the proposed rule in July. The final rule will be published Nov. 8. Home infusion Per the rule, CMS will group home infusion drugs into three payment categories, each with a unit of single payment, paid at amounts in accordance with specified infusion codes and...

AAHomecare, Competitive Bidding, End-Stage Renal Disease (ESRD), Final Rule, ResMed, Rotech Healthcare


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News

CMS issues final ESRD rule

October 31, 2019HME News Staff

WASHINGTON - CMS on Thursday afternoon released an ESRD final rule that establishes a permanent home infusion therapy benefit in 2021 and establishes a methodology for establishing fee schedules for new DMEPOS items. CMS published the proposed rule in July. The final rule will be published Nov. 8. Home infusion Per the rule, CMS will group home infusion drugs into three payment categories, each with a unit of single payment, paid at amounts in accordance with specified infusion codes and...

End-Stage Renal Disease (ESRD), Final Rule, Home Medical Equipment (HME)


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Also Noted

NHIA pushes for clarifications

January 2, 2019HME News Staff

WASHINGTON - The National Home Infusion Association has submitted comments to CMS asking the agency to issue sub-regulatory guidance that clarifies that home infusion services are reimbursed on any day a patient receives a professional service. The NHIA also asks the agency to establish a billing mechanism that distinguishes between professional services provided in the home by a nurse, and remote pharmacy services. “These changes would allow home infusion and homecare providers to collaborate...

Final Rule, Home Infusion


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Also Noted

Group: Final rule didn't go far enough on liquid oxygen

November 6, 2018HME News Staff

WASHINGTON - A group of patient and physician groups has expressed its disappointment that CMS did not carve out liquid oxygen from its competitive bidding program in a recently released final rule. “Despite CMS's acknowledgement of the problems facing patients, especially those who require liquid oxygen, we are disappointed that the administration chose not to use its full statutory authority to ensure that all patients who require supplemental oxygen receive the treatment they need, or even...

Competitive Bidding, Final Rule, Liquid oxygen


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Stakeholders unpack disappointing final rule

November 2, 2018Theresa Flaherty, Managing Editor

WASHINGTON - The lack of substantial changes in the competitive bidding-related final rule likely comes down to cost, say HME industry stakeholders.“The challenge has all along been the cost,” said Tom Ryan, president and CEO of AAHomecare. “I think the political appointees at the agency wanted to do more but were restricted by cost. Cost is everything.”The final rule, released Nov. 1, did not include two areas of additional relief requested by the industry: an extension of...

Competitive Bidding, Final Rule, Reform, Relief


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