Tag: Final Rule

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,...

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, CMS says....

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...

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...

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...

WASHINGTON - CMS appears to have done little to change its competitive bidding-related rule from the time it was proposed in July until it was finalized on Nov. 1.Despite myriad concerns raised by HME industry stakeholders, the agency did not extend 50/50 blended reimbursement rates to all non-bid areas; and it did not apply CPI adjustments to rates in bid areas retroactively from 2008-13.“While I believe that CMS is making a smart decision in pausing the bidding program to work on additional...

ATLANTA - CMS's final rule with significant changes to the competitive bidding program has moved to the Office of Management and Budget for clearance, Tom Ryan told Medtrade attendees at Tuesday morning's AAHomecare Washington Update.“That's breaking news,” said Ryan, president and CEO, who learned of the development as the session was drawing to a close.Stakeholders expect the final rule to be published in November. An earlier proposed rule received 514 comments by its Sept. 10 deadline.“That's...

WASHINGTON - A sign-on letter in the House of Representatives that seeks additional relief from Medicare's competitive bidding program has nearly 100 signatures, VGM Group reports this week.The deadline for collecting signatures for the letter, spearheaded by Rep. Cathy McMorris Rodgers, R-Wash., is this Friday, Oct. 5.“Great work reaching out to your member of Congress,” VGM stated in a bulletin.The letter will be sent to CMS Administrator Seema Verma, HHS Secretary Alex Azar and OMB...

WASHINGTON - A Senate sign-on letter supporting additional relief from Medicare's competitive bidding program was released this morning, a companion letter to one circulating in the House of Representatives which has garnered 79 signatures so far.The Senate letter, spearheaded by Sens. John Thune, R-S.D, and Heidi Heitkamp, D-N.D., urges CMS to increase reimbursement rates in bid areas until the next round of the program is implemented and extend 50/50 blended reimbursement rates to all non-bid areas...

WASHINGTON - Forty members of the House of Representatives have so far agreed to add their names to a sign-on letter that makes the case for additional relief from Medicare's competitive bidding program, AAHomecare reports.The letter, spearheaded by Rep. Cathy McMorris Rodgers, R-Wash., pushes CMS to increase reimbursement rates in bid areas until the next round of the program is implemented and extend 50/50 blended reimbursement rates to all non-bid areas as part of its forthcoming final rule.“Please...