Tag: Capped Rental

ROCKY HILL, Conn., and FRANKLIN, Tenn. - The capped rental rule will squeeze cash flow and generate more paperwork, national mobility providers say, but it's not altering their strategies just yet.The rule, which went into effect in April, requires providers to send claims to Medicare and secondary payers each month of a 13-month rental period to receive full payment.“There may be a time in the future where we have to assess what products we put out the door,” said Kevin Harmon, vice...

YARMOUTH, Maine - What's the impact on manufacturers of the transition to capped-rental status for certain complex rehab items?So far, they're hedging their bets.The transition went into effect April 1, prompting some providers, such as Monroe Wheelchair, to discontinue providing items like power-assist devices.But Exeter, Pa.-based Pride Mobility and Quantum Rehab report little impact from the change, mostly because it's “largely a manual and pediatric wheelchair issue,” which isn't...

WASHINGTON - Although providers hoped to hear “April Fools,” the rule transitioning certain complex rehab items to capped-rental status went into effect Tuesday as planned.“This change in regulation is so ridiculous, and the basis behind it is so ridiculous, that my Pollyanna personality made me believe we were really going to get a delay or have the whole thing retracted,” said Doug Westerdahl, president of Monroe Wheelchair.Stakeholders and lawmakers called on CMS to delay...

WASHINGTON - A group of lawmakers has asked CMS to delay the transition of certain complex rehab items to capped-rental status on April 1.In a March 6 letter to CMS Administrator Marilyn Tavenner, two senators and two representatives ask the agency to delay the transition until at least July 1 “to allow for the development of appropriate classification policies that provide patients with medically-necessary CRT equipment in a reasonable and cost-effective way.”CMS has based its decision...

WASHINGTON - A group of lawmakers has written to CMS Administrator Marilyn Tavenner to express concerns with CMS's plans to transition certain complex rehab items to capped-rental status on April 1. In the March 6 letter, the two representatives and two senators ask CMS to delay the transition until at least July 1 “to allow for the development of appropriate classification policies that provide patients with medically necessary CRT equipment in a reasonable and cost-effective way.” Industry...

WASHINGTON - CMS announced Feb. 24 that it seeks public comments on how to take its competitive bidding program for DME nationwide on Jan. 1, 2016.“While the methodology will be proposed in future rulemaking, CMS is first requesting comments on several aspects that it would consider in developing a methodology to adjust DMEPOS fee schedule amounts or other payment amounts in non-competitive areas based on the DMEPOS competitive bidding payment information,” CMS states in a fact sheet.Specifically,...

Complex rehab stakeholders say lawmakers had the same reaction they did to Medicare's plan to transition certain complex rehab codes to capped rental status.“They were surprised that CMS relied on 27-year-old data to make their decision, and that more than 170 comments were ignored,” said Don Clayback, executive director of NCART. “CMS has taken a situation that was working, with no funding or access problems, and created a problem with payment and access.”Stakeholders met...

WASHINGTON - The day-to-day reality of providing certain complex rehab equipment as capped rental items is unrealistic, providers say.“CMS is asking DME companies to provide complex rehab and finance Medicare over 13 months, when we have to pay the vendors back in 60 days,” said Patrick Mahncke, president of Denver, Colo.-based USA Mobility. “From a business standpoint, it's very difficult to do that.”On April 1, CMS plans to make 78 codes capped rental items, including manual...

There's a great deal of activity regarding healthcare policy changes with the goal of providing quality care and services in the most cost-effective manner. But to be successful, the process must include input from all parties so that changes are made in a fully informed manner and result in the most effective and positive outcomes. That's not happening when it comes to Medicare's coverage of complex rehab technology (CRT).Medicare policy changes impacting CRT during the past year fall under negative...

WASHINGTON - CMS's decision to pay for repairs for capped rental DME provided by The Scooter Store and transferred to beneficiaries on Oct. 24 is a step in the right direction, but not a solution, industry stakeholders say.“Before this, no provider could touch those chairs,” said Martin Szmal, founder of The Mobility Consultants. “Now providers can follow the same guidelines of any beneficiary-owned power wheelchair.”CMS stated in a bulletin last week that Medicare would pay...