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Tag: Competitive Bidding


News

In brief: AAH pushes for follow up, StateServ buys PBM, ADS builds C-suite 

January 24, 2024HME News Staff

WASHINGTON – The U.S. House of Representatives passed a short-term spending bill on Jan. 18 to keep the government funded until the beginning of March, AAHomecare reports, but the bill does not contain various health care extender measures, including the industry’s provision to extend the 75/25 blended Medicare reimbursement rates in non-rural areas.  “We are continuing to work with our champions, as well as influential legislators and committee staff, to pass our legislation...

AAHomecare, Advanced Diabetes Supply, Benefits Manager, Competitive Bidding, reimbursement relief, StateServ


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News

Reimbursement relief: 'Please follow up,’ AAH says 

January 22, 2024HME News Staff

WASHINGTON – The U.S. House of Representatives passed a short-term spending bill on Jan. 18 to keep the government funded until the beginning of March, AAHomecare reports, but the bill does not contain various health care extender measures, including the industry’s provision to extend the 75/25 blended Medicare reimbursement rates in non-rural areas.  “We are continuing to work with our champions, as well as influential legislators and committee staff, to pass our legislation...

AAHomecare, Blended Rates, Competitive Bidding, reimbursement relief


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News

CMS announces 3% increase 

December 12, 2023HME News Staff

WASHINGTON – CMS has announced a 3% CPI-U adjustment to the DMEPOS fee schedule for calendar year 2024, AAHomecare has reported, but the actual amount will be influenced by Medicare’s competitive bidding program.  The adjustment varies as follows:     • CBP items in former CBAs (projected percentage change): +2.9%     • CBP items in non-CBAs (CPI-U): +3% (not directly stated in the change request)     • Non-CBP items...

Competitive Bidding, Consumer Price Index (CPI), fee schedule


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HME Newspoll

News

HME providers remain skeptical of CMS’s plans for competitive bidding 

June 16, 2023Theresa Flaherty, Managing Editor

YARMOUTH, Maine – No matter what CMS does going forward with its competitive bidding program, it’s no surprise that the respondents to a recent HME Newspoll feel the program is unsalvageable.  As part of the announcement in May of a temporary gap in the program, CMS stated it plans to “implement necessary changes” to the program to establish sustainable prices and create savings for Medicare beneficiaries and taxpayers.  “The bid program should go away,”...

Competitive Bidding, HME NewsPoll


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News

Regulatory update: Ventilator access, bid relief support 

June 15, 2023HME News Staff

ARLINGTON, Va. – AAHomecare and the ALS Association asked CMS to promptly issue a memorandum clarifying medical policy and coverage of non-invasive ventilators (NIVs) and take steps to expedite authorizations for people living with ALS.  They shared their concerns about reports of denials as high as 86% and 64% for two major MA plans, with rates in the low teens for other MA plans. They report issues for both new setups and continued authorizations.  “The ALS Association...

AAHomecare, Amyotrophic Lateral Sclerosis (ALS), Competitive Bidding, Non-invasive ventilator, Reimbursement


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Jay Witter

News

Competitive bidding: Stakeholders on watch for further developments  

June 2, 2023Theresa Flaherty, Managing Editor

WASHINGTON – Industry stakeholders will keep an eye on CMS as it takes next steps toward a new round of competitive bidding and will act to preserve current guardrails for the program, they say.   CMS on May 25 announced a temporary gap period in the program starting Jan. 1, 2024. Contracts for off-the-shelf back and knee braces for the current round, Round 2021, expire on Dec. 31, 2023.    “It takes 18 months or more to get the bid program up and running and...

AAHomecare, Competitive Bidding, Reimbursement


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Also Noted

CMS adds ZIP code to Round 2021

March 23, 2023HME News Staff

WASHINGTON - The following ZIP code has been added to Round 2021 of the DMEPOS competitive bidding program to conform with United States Postal Service ZIP code changes within the identified competitive bidding area (CBA): 56963 Washington, DC CBA. No HCPCS codes were added or removed during this quarter. CMS has not indicated when it may hold any future rounds of the bidding program, after the last round largely failed due to lack of cost savings.

Competitive Bidding, Home Medical Equipment (HME)


John Gallagher

News

Industry reaches ‘inflection point’ in bid areas

January 6, 2023Liz Beaulieu, Editor

Industry scored major wins in an end-of-year spending bill  But, outside of annual updates, reimbursement relief in former competitive bidding areas has been elusive  Stakeholders are now working on a strategy for providing relief in those areas, but CMS’s plans for the next round of bidding is an obstacle  WASHINGTON – Industry stakeholders “left everything on the field” in December, paving the way for Congress to pass several HME-related provisions...

AAHomecare, Competitive Bidding, Home Medical Equipment (HME), VGM


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Jay Witter

News

AAHomecare: Turn pain into action 

August 12, 2022Theresa Flaherty, Managing Editor

WASHINGTON – Rising inflation, outdated reimbursement and competitive bidding were the topics of conversation during a recent meeting between industry stakeholders and CMS officials.  Stakeholders have been ramping up questions about the bidding program, in particular, after a vague notice of proposed rulemaking with a December date was included in the Unified Agenda.  “I didn’t see any sense of urgency (from CMS) in moving forward and certainly from a timeline standpoint,...

AAHomecare, Competitive Bidding, inflation, Reimbursement


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John Gallagher

News

Stakeholders search for intel on bid program

July 8, 2022Theresa Flaherty, Managing Editor

WASHINGTON – With CMS staying mum on a possible next round of the competitive bidding program, stakeholders want to know, “What’s the plan?”  “Nobody knows what CMS is doing or what their game plan is, as far as the next round of bidding,” said John Gallagher, vice president of government relations for VGM. “It’s supposedly out there for December, but nobody knows if that is only for braces or what it is they will push and, in the meantime,...

AAHomecare, Competitive Bidding, H.R. 6641, Home Medical Equipment (HME), VGM


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