Tag: Medicare
MedPAC reports on Medicare payment incentives, enrollment decisions & more
June 16, 2026HME News Staff
WASHINGTON – The Medicare Payment Advisory Committee (MedPAC) has released its June 2026 Report to Congress: Medicare and the Health Care Delivery System to highlight issues affecting the Medicare program, as well as broader changes in health care delivery and the market for health care services.
The report includes six chapters:
Improving payment incentives in Medicare: We describe incentives in fee-for-service (FFS) Medicare, alternative payment models (APMs), and Medicare Advantage...
New research questions Medicare’s 90-day rule for CPAP adherence
June 11, 2026HME News Staff
ORLANDO, Fla. – Many insurers stop covering continuous positive airway pressure (CPAP) devices if patients don’t use them regularly in the first 90 days. But new research presented at the ATS 2026 International Conference shows that many patients who initially struggle to meet these early-use thresholds do go on to use and benefit from CPAP therapy.
The findings challenge long-held assumptions that poor early use predicts long-term CPAP use, said first author Dennis Hwang, MD, a sleep...
New accreditation cycle raises costs, burdens
June 5, 2026Theresa Flaherty
YARMOUTH, Maine – Home medical equipment (HME) providers who are preparing for resurvey and reaccreditation say CMS's move to an annual requirement adds significant administrative burden with little perceived benefit.
Providers push back on annual requirement
As part of its final rule on the competitive bidding program, CMS began requiring all providers to undergo annual reaccreditation starting Jan. 1, 2026 – a shift from the previous three-year cycle.
Providers say...
Campaign launches to stop bidding for urological, ostomy supplies
June 1, 2026HME News Staff
WASHINGTON – A group of national patient advocacy organizations has launched “The High Cost of Low Bids,” a campaign urging policymakers to stop the inclusion of urological and ostomy supplies in Medicare’s competitive bidding program.
The campaign responds to a decision by the Centers for Medicare & Medicaid Services (CMS) to include these supplies in the CBP, warning that applying a lowest-bid purchasing model to clinically complex, highly individualized products could...
CMS extends prior authorization exemption deadline
May 20, 2026HME News Staff
WASHINGTON – The Centers for Medicare & Medicaid Services (CMS) has extended the deadline to opt out of prior authorization and continue submitting requests to May 26, AAHomecare reports.
This extension only applies to suppliers that received a letter from the DME MACs in early March regarding their prior authorization exemption status.
The updated MAC notice specifies:
If you reached exemption and want to continue submitting prior authorization requests, you must submit the opt-out...
Stakeholders press CMS for clarification on vent requirement
May 14, 2026HME News Staff
WASHINGTON – AAHomecare has joined several advocacy and patient groups in signing a letter to CMS Administrator Mehmet Oz requesting immediate clarification on guidance for continuing-use criteria for home mechanical ventilators (HMVs) and respiratory assist devices (RADs) for Medicare beneficiaries with chronic respiratory failure due to COPD. In the absence of clear guidance, informal supplier surveys show that more than 50% of beneficiaries using HMVs or RADs could be required to return...
CMS expands scope of stay-of-enrollment
May 14, 2026HME News Staff
WASHINGTON – The Centers for Medicare & Medicaid Services on May 18 will begin applying additional scenarios where stay-of-enrollment can be applied on non-compliant DMEPOS suppliers, AAHomecare reports. Those scenarios:
Liability insurance and surety bond cancellations
Site visit non-compliance determinations
Failure to respond to development requests within 30 days for revalidations or changes to information
Background
Stay-of-enrollment is a preliminary action CMS can take...
CMS announces moratorium on hospice, home health agency enrollments
May 13, 2026HME News Staff
WASHINGTON – The Centers for Medicare & Medicaid Services (CMS) will implement a six-month, nationwide data-driven moratorium on new Medicare enrollment for hospices and home health agencies (HHAs).
CMS says the moratorium, which will temporarily halt the influx of new providers into these high-risk categories, continues the Trump Administration’s crackdown on fraud, waste and abuse in the Medicare program.
“We’ve seen systemic and deeply troubling fraud in the hospice...
In brief: Appeals transition, Insulet raise, Heartland keynotes
May 8, 2026HME News Staff
WASHINGTON – The Centers for Medicare & Medicaid Services (CMS) has announced that, effective May 8, 2026, Chags Health Information Technology LLC (C-HIT) will no longer handle DMEPOS appeals and rebuttals. Responsibility for processing these submissions will transition to the National Provider Enrollment (NPE) DMEPOS contractors.
The two NPE contractors are: Palmetto GBA for the western half of the country (NPEC West) and Novitas for the eastern half (NPEC East).
What this...
DMEPOS appeals, rebuttals transition to NPE contractors
May 6, 2026HME News Staff
WASHINGTON – The Centers for Medicare and Medicaid Services (CMS) has announced that, effective May 8, 2026, Chags Health Information Technology LLC (C-HIT) will no longer handle DMEPOS appeals and rebuttals. Responsibility for processing these submissions will transition to the National Provider Enrollment (NPE) DMEPOS contractors.
The two NPE contractors are: Palmetto GBA, for the western half of the country (NPEC West) and Novitas for the eastern half (NPEC East).
What...