Tag: rural areas

WASHINGTON - A group of senators and representatives from West Virginia has sent a letter to CMS Administrator Seema Verma saying the agency's May 9 interim final rule “does not go far enough” to ensure continued access to DME for the elderly and disabled in rural areas.The group points out that, while the IFR reinstates 50/50 blended reimbursement rates, it only does so for rural and non-contiguous areas, not all non-competitive bidding areas.“We were hopeful that the IFR would...

WASHINGTON - A competitive bidding-related interim final rule had 136 comments on Monday, July 9, the deadline.Stakeholders have been pushing for comments on the IFR, which reinstates 50/50 blended reimbursement rates—but only from June 1, 2018, to Dec. 31, 2018, instead of retroactively from Jan. 1, 2017; and only in rural and non-contiguous areas instead of all non-bid areas.The deadline or submitting comments is July 9.Submit your comments here.

WASHINGTON - CMS last week published the adjusted reimbursement rates that will go into effect for seven months in rural areas.The adjustments, called for in a recently released interim final rule, means reimbursement for oxygen concentrators, for example, will go from $77.16 to $121.46 per month from June 1 through Dec. 31 in rural areas.Per the IFR, CMS is reverting to 50/50 blended reimbursement rates in rural areas, but not in all non-bid areas, as stakeholders had hoped.Other examples include...

WATERLOO, Iowa - Residents in rural states will have to travel further to reach an HME provider when Medicare applies competitive bid pricing nationwide on Jan. 1, according to a new study.Residents living in rural areas in Montana, North Dakota, Oregon, Washington state, West Virginia and Wisconsin will all be affected by the change, according to the study from the GeoTree Center at the University of Northern Iowa in Cedar Falls.In North Dakota, for example, residents in rural areas will have to...

WASHINGTON - CMS has released revised fee schedule amounts for 11 product categories as part of its national roll out of competitive bid pricing on Jan. 1.CMS has based pricing in rural areas on the national weighted average plus 10%.For oxygen concentrators, for example, that means a 22% reduction in reimbursement, on average, in rural areas from 2015 to 2016.CMS plans to phase-in new pricing over six months. Starting Jan. 1, pricing will be based on a 50/50 blend of the current and adjusted...

WASHINGTON - A bipartisan bill to “smooth the transition” to competitive bid pricing in rural areas dropped today in the Senate.Introduced by Sens. John Thune, R-S.D., and Heidi Heitkamp, D-N.D., the DME Access and Stabilization Act seeks to ensure HME providers can still serve Medicare beneficiaries, according to a press release.“It is important that people receive quality health care, no matter where they live,” said Thune. “Not only does this legislation ensure that...

WASHINGTON - All eyes last week were on CMS's preliminary list of rural zip codes for the national roll out of competitive bidding, with HME providers doing business in those areas set to feel a little less of a cut.CMS plans to implement bid pricing nationwide on Jan. 1, 2016, with separate fee schedules for regional and rural areas. For regional areas, the agency will base pricing on the average pricing in the competitive bidding areas in the region; for rural areas, it plans to base pricing on...

WASHINGTON - CMS has released a revised fee schedule format and a preliminary list of rural zip codes for the national roll out of competitive bidding.The agency had previously announced plans to apply bid pricing in non-bid areas on Jan. 1, 2016, by using regional prices limited by a national ceiling (110% of the average of regional prices) and floor (90% of the average of regional prices). Pricing will be slightly higher in rural areas.While industry stakeholders were still digging through the...

YARMOUTH, Maine - HME providers, especially those in rural areas, are making tough business decisions in preparation for Medicare's national rollout of competitive bidding pricing on Jan. 1.A number of providers in these areas say they're limiting the number of brands they carry for each product category and giving preference to less costly products.“It eliminates patient choice and forces us, as a company, to put out a brand that's perhaps not as good,” said Amy Schmidt, a partner at...