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reimbursement

OIG: Medicare pays too much for non-invasive vents

Agency recommends CMS include E0466 in bid program ‘as soon as possible’
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09/22/2020

WASHINGTON – Medicare pays more for non-invasive ventilators than certain other payers, according to a new report from the Office of Inspector General.

Relief on the way for complex rehab providers

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12/20/2019

WASHINGTON – In a hard-fought win, industry stakeholders have succeeded in getting Congress to suspend competitive bidding pricing for accessories for complex manual wheelchairs.

CMS addresses reimbursement for new technology

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07/30/2019

WASHINGTON – CMS is proposing a rule to establish methodologies to modernize pricing of new DMEPOS items and services, the agency announced July 29.

NSM launches new reimbursement system

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06/14/2019

NASHVILLE, Tenn. – National Seating & Mobility has launched an automated expected reimbursement system.

Cures update: Georgia Medicaid reverses course

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03/01/2018

ATLANTA – HME industry stakeholders have succeeded in steering Georgia away from basing its Medicaid reimbursement on competitive bidding-based Medicare reimbursement, AAHomecare reported this week.

CMS starts implementation process for Cures provision

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11/28/2017

WASHINGTON – CMS wants state Medicaid programs to submit their DME fee schedules using a new spreadsheet to make sure they’re not paying too much for equipment, according to a notice in the Federal Register.

Bill would fix payment gap for home infusion

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07/11/2017

WASHINGTON – Reps. Pat Tiberi, R-Ohio, and Bill Pascrell, D-N.J., have introduced a bill that would create a “temporary transitional payment” for home infusion drugs beginning Jan. 1, 2019.

CMS comes through on wheelchair accessories

‘We have a little extra bounce in our steps’
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06/23/2017

WASHINGTON – With only days to spare, stakeholders have succeeded in getting CMS to refrain from cutting reimbursement for accessories for complex rehab power wheelchairs.

Update: Custom seats, backs under review, NCART says

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04/25/2017

WASHINGTON – The medical directors at jurisdictions B and C have agreed to do an “immediate review” of payments for custom seats (E2609) and custom backs (E2617), following their decision to change payments from individually priced to flat allowable, according to NCART.

Cures Act update: Could bill in Minnesota serve as template for relief?

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04/03/2017

ST. PAUL, Minn. – Minnesota could be the first state to introduce legislation to stave off a “pay for” in the 21st Century Cures Act that limits the federal portion of Medicaid reimbursement for DME to competitive bidding-influenced Medicare reimbursement starting Jan.

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