Tag: Competitive Bidding
In brief: AdaptHealth’s static revenue, bid program’s impact, AOM’s Western expansion
November 6, 2024HME News Staff
PLYMOUTH MEETING, Pa. – AdaptHealth reported third quarter net revenue of $805.9 million compared to $804 million, an increase of 0.2% year over year.
Net income attributable to AdaptHealth was $22.9 million vs. a net loss of $454.1 million. Adjusted EBITDA was $164.3 million vs. $161.2 million, an increase of 1.9%
“I continue to be optimistic about the road ahead,” said Suzanne Foster, CEO. “We have identified growth opportunities, we are assembling a high...
Bid program had no significant impact on access, study finds
November 5, 2024HME News Staff
CHICAGO – Medicare's phased implementation of the competitive bidding program in 2011 and 2013 did not reduce oxygen use, according to the findings of a new study published in JAMA Internal Medicine. In the cohort study of 5,753,308 Medicare beneficiaries with COPD, the program was associated with only a 0.19 percentage point reduction in new oxygen prescriptions and a 0.77 percentage point reduction in oxygen discontinuations, researchers say. As such, the currently proposed legislation...
Report makes case for ‘fully funding’ DME
September 24, 2024HME News Staff
WATERLOO, Iowa – The cost of treating injuries and illnesses due to lack of DME far exceeds the cost of providing the necessary equipment, according to a new report from Leitten Consulting.
For example, every dollar spent on mobility equipment can save Medicare $62.53 in treatment costs, the report found.
“An ounce of prevention is now worth several pounds of cure,” said Brian Leitten, CEO of Leitten Consulting, which specializes in health care policy analysis...
In brief: AAH pushes for follow up, StateServ buys PBM, ADS builds C-suite
January 24, 2024HME News Staff
WASHINGTON – The U.S. House of Representatives passed a short-term spending bill on Jan. 18 to keep the government funded until the beginning of March, AAHomecare reports, but the bill does not contain various health care extender measures, including the industry’s provision to extend the 75/25 blended Medicare reimbursement rates in non-rural areas.
“We are continuing to work with our champions, as well as influential legislators and committee staff, to pass our legislation...
Reimbursement relief: 'Please follow up,’ AAH says
January 22, 2024HME News Staff
WASHINGTON – The U.S. House of Representatives passed a short-term spending bill on Jan. 18 to keep the government funded until the beginning of March, AAHomecare reports, but the bill does not contain various health care extender measures, including the industry’s provision to extend the 75/25 blended Medicare reimbursement rates in non-rural areas.
“We are continuing to work with our champions, as well as influential legislators and committee staff, to pass our legislation...
CMS announces 3% increase
December 12, 2023HME News Staff
WASHINGTON – CMS has announced a 3% CPI-U adjustment to the DMEPOS fee schedule for calendar year 2024, AAHomecare has reported, but the actual amount will be influenced by Medicare’s competitive bidding program.
The adjustment varies as follows:
• CBP items in former CBAs (projected percentage change): +2.9%
• CBP items in non-CBAs (CPI-U): +3% (not directly stated in the change request)
• Non-CBP items...
HME providers remain skeptical of CMS’s plans for competitive bidding
June 16, 2023Theresa Flaherty, Managing Editor
YARMOUTH, Maine – No matter what CMS does going forward with its competitive bidding program, it’s no surprise that the respondents to a recent HME Newspoll feel the program is unsalvageable.
As part of the announcement in May of a temporary gap in the program, CMS stated it plans to “implement necessary changes” to the program to establish sustainable prices and create savings for Medicare beneficiaries and taxpayers.
“The bid program should go away,”...
Regulatory update: Ventilator access, bid relief support
June 15, 2023HME News Staff
ARLINGTON, Va. – AAHomecare and the ALS Association asked CMS to promptly issue a memorandum clarifying medical policy and coverage of non-invasive ventilators (NIVs) and take steps to expedite authorizations for people living with ALS.
They shared their concerns about reports of denials as high as 86% and 64% for two major MA plans, with rates in the low teens for other MA plans. They report issues for both new setups and continued authorizations.
“The ALS Association...
Competitive bidding: Stakeholders on watch for further developments
June 2, 2023Theresa Flaherty, Managing Editor
WASHINGTON – Industry stakeholders will keep an eye on CMS as it takes next steps toward a new round of competitive bidding and will act to preserve current guardrails for the program, they say.
CMS on May 25 announced a temporary gap period in the program starting Jan. 1, 2024. Contracts for off-the-shelf back and knee braces for the current round, Round 2021, expire on Dec. 31, 2023.
“It takes 18 months or more to get the bid program up and running and...
CMS announces gap period in bid program
May 25, 2023HME News Staff
WASHINGTON – CMS has announced there will be a temporary gap period in the DMEPOS competitive bidding program, when the current Round 2021 contracts for off-the-shelf back and knee braces expire on Dec. 31, 2023.
During the gap period, which starts on Jan. 1, 2024, suppliers may furnish items and services to patients under the following payment rules:
Adjusted fees in former competitive bidding areas (CBAs) are based on 100% of the single payment amount for the CBA increased...