NHIA applauds, remains vigilant

ALEXANDRIA, Va. - Stakeholders were “pleasantly surprised” when external infusion pumps weren't included in the Round 2 recompete, but they say they won't let down their guard.

“We'll be doing what we can to ensure it doesn't get included in future rounds of bidding,” said Bill Noyes, vice president of health information policy for the National Home Infusion Association (NHIA).

CMS announced plans for the Round 2 recompete on July 15. External infusion pumps and insulin pumps were added as a category in the Round 1 recompete, and saw an average reimbursement cut of 21%.

The NHIA has been vocal in its objection to putting external infusion pumps out to bid, largely due to patient safety issues. It has reached out to CMS, the Competitive Bidding Implementation Contractor (CBIC) and even the U.S. Food and Drug Administration (FDA), said Noyes.

The association also set up a hotline to track patient problems in the Round 1 recompete, but it hasn't received very many complaints. 

That doesn't mean there aren't problems, said Noyes.

“I think the providers, both those that won and those that did not win, worked very diligently to make sure that patient needs were still met,” he said.

For now, the NHIA has its sights on the proposed rule to implement bundling for enteral nutrients and supplies, and to expand competitive bidding rates nationwide in 2016.

“The cost variance (for enteral nutrition) is great, as well as the administration costs, and they are looking for a single bundled payment for enteral patients once a month,” said Noyes.

The ultimate fix, as far as the NHIA is concerned? Getting external infusion pumps out from under the DMEPOS benefit, said Noyes.

“Home infusion is ill-fitted to the DME benefit structure,” he said. “The clinically intense nature of home infusion services and the careful coordination required to safely deliver these therapies in the home is critical to patient safety.”