Medicare reclassifies RADs

Tuesday, February 28, 2006

BALTIMORE - In a move that AAHomecare claims will put some beneficiaries at risk, CMS in late January reclassified respiratory assist devices (RADs) as capped rental DME items.
CMS's final rule states that the devices will no longer be considered DME items that require frequent and substantial servicing, beginning April 1, 2006.
Per the new payment classification, beneficiaries will pay $96 per month in co-insurance to use the devices. After 13 months, beneficiaries have the option of taking ownership. If they do, they no longer have to pay co-insurance to rent the devices.
Currently, beneficiaries pay up to $128 per month for as long as they're using RADs.
CMS's decision dismayed AAHomecare. While Medicare will continue to pay 80% of maintenance post-rental, patients using RADs won't always be able to determine when maintenance or repairs are needed and how to arrange for those services, the association stated in a Jan. 27 release.
CMS revised the payment classification for RADs after the Health and Human Services Inspector General found that RADs do no require frequent service to justify continuous rental payments.