Tag: Final Rule
CMS finalizes reimbursement relief in rural areas
December 21, 2021HME News Staff
WASHINGTON – CMS has published the DMEPOS Final Rule, making permanent the 50/50 blended reimbursement rates in rural areas but failing to provide relief in other areas.
For contiguous, non-rural areas, CMS says it will be paying suppliers 100% of the adjusted fee schedule rates using information from the competitive bidding program. For former bid areas, it says it will be paying the single payment amounts established during the program, plus an inflation adjustment factor on an annual...
Industry readies to press forward on relief
December 10, 2021Theresa Flaherty, Managing Editor
WASHINGTON - With PAYGO-related Medicare cuts behind them, industry stakeholders are re-focusing on the DMEPOS final rule, lining up a new champion in Congress to lead reimbursement relief efforts.
On Thursday, the Senate approved legislation to prevent across-the-board, 4% PAYGO-related cuts to Medicare reimbursement from taking effect in 2022.
“It’s a large victory that resulted from a consortium of efforts from across the health care sector,” said Tom Ryan,...
Reimbursement relief: Stakeholders play all angles
July 9, 2021Theresa Flaherty, Managing Editor
WASHINGTON – Industry stakeholders say Congress is “definitely getting back to work,” after a long spring, during which there was little movement on HME issues.
Stakeholders have been meeting with industry champion Rep. Cathy McMorris Rodgers, R-Wash., to discuss legislative language for competitive bidding relief, line up a co-sponsor and identify possible vehicles for the fall, they said.
“We’ve had Hill visits, face-to-face meetings with members...
Stakeholders push for rule’s release
March 1, 2021HME News Staff
WASHINGTON – The Council for Quality Respiratory Care has partnered with AAHomecare and the VGM Group to send a one-page letter to CMS urging the agency to finalize the DMEPOS final rule as quickly as possible.
A proposed rule published in October outlined the agency’s plans to make permanent the 50-50 blended reimbursement rates in rural areas.
“In light of the pandemic, it is more important than ever that the Medicare...
CMS modernizes Stark Law
November 23, 2020HME News Staff
WASHINGTON - CMS has finalized a number of changes to the Stark Law, including new permanent exemptions for value-based arrangements, in a 627-page final rule set to be published in the Federal Register on Dec. 2.
The exemptions will allow physicians and other health care providers to design and enter into value-based arrangements without fear that legitimate activities to coordinate and improve the quality of care for patients and lower costs would violate the physician self-referral law,...
In brief: CMS publishes final rule, Rotech taps $50M for acquisitions
November 1, 2019HME News Staff
WASHINGTON - CMS on Thursday afternoon released an ESRD final rule that implements a permanent home infusion therapy benefit in 2021 and establishes a methodology for establishing fee schedules for new DMEPOS items.
CMS published the proposed rule in July. The final rule will be published Nov. 8.
Home infusion
Per the rule, CMS will group home infusion drugs into three payment categories, each with a unit of single payment, paid at amounts in accordance with specified infusion codes and...
CMS issues final ESRD rule
October 31, 2019HME News Staff
WASHINGTON - CMS on Thursday afternoon released an ESRD final rule that establishes a permanent home infusion therapy benefit in 2021 and establishes a methodology for establishing fee schedules for new DMEPOS items.
CMS published the proposed rule in July. The final rule will be published Nov. 8.
Home infusion
Per the rule, CMS will group home infusion drugs into three payment categories, each with a unit of single payment, paid at amounts in accordance with specified infusion codes and...
NHIA pushes for clarifications
January 2, 2019HME News Staff
WASHINGTON - The National Home Infusion Association has submitted comments to CMS asking the agency to issue sub-regulatory guidance that clarifies that home infusion services are reimbursed on any day a patient receives a professional service. The NHIA also asks the agency to establish a billing mechanism that distinguishes between professional services provided in the home by a nurse, and remote pharmacy services. “These changes would allow home infusion and homecare providers to collaborate...
Group: Final rule didn't go far enough on liquid oxygen
November 6, 2018HME News Staff
WASHINGTON - A group of patient and physician groups has expressed its disappointment that CMS did not carve out liquid oxygen from its competitive bidding program in a recently released final rule. “Despite CMS's acknowledgement of the problems facing patients, especially those who require liquid oxygen, we are disappointed that the administration chose not to use its full statutory authority to ensure that all patients who require supplemental oxygen receive the treatment they need, or even...
Stakeholders unpack disappointing final rule
November 2, 2018Theresa Flaherty, Managing Editor
WASHINGTON - The lack of substantial changes in the competitive bidding-related final rule likely comes down to cost, say HME industry stakeholders.“The challenge has all along been the cost,” said Tom Ryan, president and CEO of AAHomecare. “I think the political appointees at the agency wanted to do more but were restricted by cost. Cost is everything.”The final rule, released Nov. 1, did not include two areas of additional relief requested by the industry: an extension of...