Tag: Bundled Payments
Regulatory news: CMS revamps audits, lawmakers question CPAP bundling
August 18, 2017HME News Staff
WASHINGTON - Claims submitted by providers that have the highest claim error rates or billing practices that vary significantly from their peers will soon face increased scrutiny, CMS has announced.
As part of an expanding “Targeted Probe and Educate” program, the Medicare Administrative Contractors will identify these providers through data analysis.
“TPE claim selection is different from that of previous probe and educate programs,” the agency stated in an Aug. 14...
House questions CPAP bundling program
August 17, 2017HME News Staff
WASHINGTON - A bipartisan group in the House of Representatives is circulating a congressional sign-on letter that asks CMS to delay a CPAP bundling pilot program from the next round of competitive bidding.The letter states a number reasons for delaying the program, including the lack of evidence that it will save money or enhance care, and CMS's lack of authorization to test alternative payment models as part of its competitive bidding program.“Instead, we encourage the agency to work with...
Stakeholders question authority to bundle
March 23, 2017HME News Staff
WASHINGTON - CMS does not have the authority to implement bundled bidding programs for CPAP or other HME, because it would jeopardize patient access to specific equipment, say industry stakeholders.
Bundling a CPAP device, consumable items, maintenance and service into a single monthly payment will cause disruption for suppliers and will provide an incentive to furnish inferior products and provide a lower quality of care to compensate for shrinking margins, said AAHomecare in its weekly newsletter.
Additionally,...
Get out in front of bundled payments, Seibels says
April 3, 2015Theresa Flaherty, Managing Editor
LAS VEGAS - CMS's plan to use bundled payments isn't popular, but the initiative could, ultimately, help HME providers show their worth as cost-savers, says Emmet Seibels, who spoke at Medtrade Spring last week.“DME gets seen as a cost,” said Seibel, president of Verus Healthcare, a healthcare supply company based in Franklin, Tenn. “DME produces great results. We need to flip the perception of DME from a cost center.”CMS in October released a final rule detailing its plans...
CPAP bundling: 'Fix' for non-existent problem
December 5, 2014Theresa Flaherty, Managing Editor
WASHINGTON - Providers don't know what to make of CMS's plan to implement bundled payments for CPAP, but say they doubt it's a good thing.
“There's nothing to go by yet, but the sheer concept is counterintuitive as far as patient care,” said Chris Rice, CEO of Riverside, Calif.-based Diamond Respiratory Care. “We want to keep them compliant and keep good supplies on them, but now we are flipping the coin and creating an incentive to provide fewer supplies.”
CMS...
Industry presses for details on bundling
November 26, 2014Theresa Flaherty, Managing Editor
WASHINGTON - Industry stakeholders are seeking answers to a laundry list of questions regarding CMS's “incredibly vague” plan to bundle payments for standard power wheelchairs and CPAP.
“We've posed several questions already and will submit about a dozen more,” said Kim Brummett, senior director of regulatory affairs for AAHomecare. “CMS has indicated they are compiling the questions and will respond to the industry. CMS knows the bundling thing is incredibly...
Bundling 'problematic' for power wheelchairs
November 26, 2014Tracy Orzel
WASHINGTON - HME stakeholders are deeply concerned about CMS's plan to bundle payments for power wheelchairs and the impact that will have on patients and providers' bottom lines.
In a final rule issued Oct. 31, CMS stated that it would implement a demo project in 12 competitive bid areas, in which providers would submit a single bid for furnishing standard power wheelchairs, related accessories and services needed on a monthly basis.
Bundling is not an unreasonable concept, but CMS'...
CMS finalizes rule on bidding, bundling
November 7, 2014Theresa Flaherty, Managing Editor
WASHINGTON - CMS plans to move forward with its plans to implement competitive bid pricing nationwide, despite widespread opposition from the HME industry.
“This is a big deal,” said Kim Brummett, senior director of regulatory affairs for AAHomecare.
The agency issued its final rule Oct. 31. The proposed rule was published in July.
The biggest concern: the application of bid rates in non-competitive bidding areas (CBAs), beginning Jan. 1, 2016 and phased-in over a six-month time...
Sleep landscape: An open letter to Marilyn Tavenner
September 9, 2014Ed Grandi
Dear Ms. Tavenner: I write this letter based on my experience as the executive director of the American Sleep Apnea Association from May 2004 to March 2014. The opinions and recommendations expressed here are my own and not those held by the association.During my tenure at the association, significant changes have come about in health care, in general, and for obstructive sleep apnea (OSA) in particular. The decision to allow for physician payment for prescription of positive airway pressure (PAP)...
Bidding and bundling: Providers heed call to comment
September 5, 2014Theresa Flaherty, Managing Editor
WASHINGTON - Industry stakeholders say a large number of providers answered the call to submit comments by Sept. 2 on a proposed rule to, among other things, expand the competitive bidding program nationwide.
More than 4,000 comments were submitted on the overall rule, and stakeholders believe a good number of them pertained to the bid expansion and another HME provision to create bundled monthly payments.
“The feedback we've gotten from providers spoke to rural healthcare access,”...