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HHS budget proposes bid process for rural areas

HHS budget proposes bid process for rural areas

WASHINGTON - The budget for the Department of Health and Human Services for fiscal year 2019 proposes two tweaks to Medicare's competitive bidding program for DME.

First, HHS proposes eliminating the requirement that CMS pay a single payment amount based on the median bid amount and, instead, pay contract suppliers at their own bid amounts. Second, the agency proposes expanding the actual bidding process to all areas of the country, including rural areas.

“Expanding competitive bidding to rural areas will set prices for items and services in rural areas based on competitions in those areas rather than on competitions in urban areas,” the budget states.

HHS says in the event that less than two suppliers submit bids in a rural area, CMS will use a reference price from other, similar rural areas.

The agency says these changes will result in $6.5 billion in savings over 10 years.

The HHS budget also proposes eliminating what it calls the unnecessary requirement of a face-to-face provider visit for DME.

“Currently, physicians must document a beneficiary's face-to-face encounter with a physician or non-physician practitioner as a condition for Medicare payment for a durable medical equipment order, which can be overly burdensome on providers and suppliers,” the budget states. “This proposal enables CMS not to impose this face-to-face requirement on all providers.”


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