CMS provides limited bid relief

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Wednesday, May 9, 2018

WASHINGTON – CMS will publish an interim final rule in the Federal Register on May 11 that resumes reimbursement rates for DME included in the competitive bidding program to the 50/50 blended rates from June 1, 2018, to Dec. 31, 2018, in rural areas.

“This action will help Medicare beneficiaries in rural areas continue to access life-sustaining DME, like oxygen equipment,” said CMS Administrator Seema Verma.

In 2016 and 2017, information from the bid program was used to adjust Medicare payments for certain DME and enteral nutrition in rural areas. Beginning Jan. 1, 2017, the fully adjusted fee schedule rates were, on average, 50% lower than the unadjusted rates in these non-bid areas based on the average reduction in payment for all of the items and services subject to the adjustments, weighted by volume. In 2016, prior to the fully adjusted fee schedule rates going into effect, blended rates of 50% of the amount based on the competitive bid rates and 50% of the traditional fee schedule amounts were implemented for the transitional year period. The rule would resume those blended rates from June 1, 2018, to Dec. 31, 2018.

CMS says it is continuing to engage with stakeholders regarding the bid program and payment for items and services furnished in rural areas.

“Going forward, CMS will continue to review data and information about rates for DMEPOS items and services, as required under section 16008 of the 21st Century Cures Act,” the agency states. “CMS intends to undertake subsequent notice-and-comment rulemaking to address the rates for durable medical equipment and enteral nutrition furnished in 2019 and beyond.”

CMS will collect comments on the rule through July 9.
 

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