Tag: Competitive Bidding

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,”...

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...

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...

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.

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...

WASHINGTON – Rising inflation, outdated reimbursement and competitive bidding were the topics of conversation during a recent meeting between industry stakeholders and CMS officials.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,...

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,...

WASHINGTON – Members of the House of Representatives need to hear about the HME industry’s support for H.R. 6641, a bill that would implement a 90/10 blended reimbursement rate for Medicare in competitive bidding areas, AAHomecare says.  “AAHomecare has been in contact with multiple congressional offices since H.R. 6641 was introduced on Feb. 8,” the association stated in a bulletin. “While legislators and staff are familiar with the challenges the HME community...

WASHINGTON – Reps. Markwayne Mullin, R-Okla., and Paul Tonko, D-N.Y., have introduced a bill that would implement a 90-10 blended reimbursement rate for the 13 product categories that were removed from the current round of Medicare’s competitive bidding program.  The DMEPOS Relief Act would implement a previously used rate by CMS based 90% on bid pricing and 10% on the 2015 fee schedule, representing about a 10% to 15% increase compared to the current rates, to help address...

WASHINGTON – CMS and the Competitive Bidding Implementation Contractor have launched a redesigned home page. The new, user- and mobile-friendly page features improved aesthetics, simplified visual content emphasizing the current competitive bidding program phase, one-click easy access to each phase, and a new display of upcoming events. The site also has contract supplier FAQs that answer general questions about the DMEPOS CBP and Connexion FAQs to assist in locating and completing forms in...