Tag: National Coverage Determination (NCD)
Senators ask CMS to reconsider ‘in-the-home' requirement
September 18, 2023HME News Staff
WASHINGTON – Sens. Maggie Hassan, D-N.H., Marsha Blackburn, R-Tenn., Bob Casey, D-Pa., and Tammy Duckworth, D-Ill., are asking CMS to conduct a full review of its national coverage determination (NCD) for mobility assistive equipment for Medicare beneficiaries, including its interpretation of the “in-the-home" requirement.
Current Medicare coverage limitations on equipment used outside the home can limit a beneficiary’s access to mobility equipment and their communities,...
Disruption, innovation and growth in first half of 2023
July 18, 2023Liz Beaulieu, Editor
We’ve burned through the first half of 2023 already and what do we have to show for it?
If the most read stories from January through June are any indication, it’s disruption, innovation and growth.
Let’s start with disruption. It has come in a number of forms in 2023, including one of the HME industry’s legacy manufacturers, Invacare, filing for bankruptcy. We posted a story about that to our website in February, and it remains the most read story of the...
CMS finalizes coverage for seat elevation systems
May 16, 2023HME News Staff
WASHINGTON – CMS late on Tuesday posted a final benefit category determination and national coverage decision for seat elevation systems as an accessory to power wheelchairs.
Effective immediately, seat elevation for Medicare-covered power wheelchairs is now considered a clinically meaningful benefit to people with Medicare who perform transfers from power wheelchairs or use the chair for mobility related activities of daily living, such as dressing, grooming, toiletry, feeding and...
CMS opens NCD for seat elevation
August 16, 2022HME News Staff
WASHINGTON – CMS has opened the National Coverage Determination for seat elevation systems used with power wheelchairs, but the agency is not reconsidering coverage for power standing systems at this time.
CMS said in May it would commit to re-opening the NCD, nearly two years after the ITEM Coalition submitted a formal request to reconsider the NCD for mobility assistive equipment to include coverage for these systems.
“Now is the time for Medicare – the...
Oxygen sign-on letter heads to CMS
August 11, 2022HME News Staff
WASHINGTON – Twenty two members of the House of Representatives have asked CMS to streamline documentation for home oxygen therapy, AAHomecare reports. A sign-on letter spearheaded by Reps. Terri Sewell, D-Ala., and Larry Bucshon, R-Ind., requests that CMS: “Use the opportunity of expanding the current National Coverage Determination for oxygen to establish a clear set of criteria to support medical necessity and instruct the contractors to rely solely on the Standard Written Order...
Complex rehab update: What is the delay?
May 20, 2022Liz Beaulieu, Editor
WASHINGTON – Sen. Tammy Duckworth, D-Ill., and Rep. Jim Langevin, R-R.I., each had calls with CMS officials this month to stress the need for the agency to take the next step in reconsidering the national coverage determination for mobility assistive equipment to include seat elevation and standing systems.
Last fall, Duckworth and Langevin orchestrated letters in the Senate and House, respectively, asking CMS to seek public comment on the ITEM Coalition’s request to reconsider...
Stakeholders have concerns with CMS’s plans for CMN
May 5, 2022Liz Beaulieu, Editor
WASHINGTON – CMS’s plan to discontinue CMNs on Jan. 1, 2023, may cause problems for HME providers trying to comply with a new national coverage determination for home oxygen therapy that went into effect Sept. 27, say industry stakeholders.
Following the release of the NCD, CMS issued change requests to push new language to the decision manual and to trigger claims processing edits to align with the new guidelines, but nothing related to eliminating the CMN for oxygen specifically....
Regulatory update: DME MACs notified, RACs limited
February 15, 2022HME News Staff
WASHINGTON – CMS on Feb. 10 published a change request notifying the DME Medicare Administrative Contractors of the agency’s new national coverage determination for home oxygen therapy.
CMS notes the following changes are effective for claims with dates of service starting Sept. 27, 2021:
expansion of oxygen coverage for acute and chronic conditions;
expansion of coverage for short and long-term need (when hypoxemia exhibited);
the ability of the MACs...
CQRC: Contact CMS about paperwork requirements
January 3, 2022HME News Staff
WASHINGTON – The Council for Quality Respiratory Care is asking industry stakeholders to contact CMS Administrator Chiquita Brooks-LaSure to standardize the paperwork requirements for home oxygen coverage.
The CQRC says requiring physicians to provide medical records could result in “the vast majority of claims being denied.”
“CMS has indicated that physicians will be required to provide their medical records instead of using a form with the information...
Good riddance: Respondents support elimination of CMN
October 22, 2021Theresa Flaherty, Managing Editor
YARMOUTH, Maine – Outdated, redundant and confusing is the common refrain from HME Newspoll respondents who overwhelmingly support CMS’s decision to eliminate the CMN requirement for home oxygen therapy.
“The CMN is an outdated tool that simply seems to supply Medicare with another means to deny claims on technicalities,” wrote Josh Turner, billing manager at McAbee Medical in Decatur, Ala. “Everything on the CMN is in the medical record, so there is no reason...