Tag: Proposed Rule
Proposed rule would establish more guardrails for Medicare Advantage
December 4, 2024HME News Staff
WASHINGTON – CMS is proposing changes to the Medicare Advantage (MA) and Medicare Part D prescription drug programs to hold them more accountable for delivering high-quality care for people with Medicare.
In the Contract Year 2026 MA and Part D proposed rule, CMS proposes addressing inappropriate use of prior authorization and internal coverage criteria, including by defining the meaning of “internal coverage criteria” to clarify when MA plans can apply utilization management,...
CMS issues rule with DME provisions
July 6, 2023HME News Staff
WASHINGTON – CMS on June 30 issued a home health proposed rule that codifies returning Medicare rates for DME in non-rural/non-CBAs to levels prior to regulatory and legislative relief during the public health emergency.
The CY 2024 Home Health Prospective Payment System Rate Update, expected to be published in the Federal Register on July 10, also contains several other DME related provisions:
Lymphedema compression garments
The proposed rule establishes a Medicare...
In brief: CMS moves on proposed rule, Paragon closes four deals, VGM updates bid study
October 22, 2021HME News Staff
WASHINGTON – CMS has sent the DMEPOS proposed rule to the Office of Management and Budget for final review, AAHomecare reports.
A letter asking CMS to act on the rule, published a year ago, garnered 95 signatures from members of the House of Representatives, including champions on the influential Ways and Means and Energy and Commerce committees.
“Capitol Hill is starting to understand the market realities and new operational environment that suppliers and manufacturers...
AAHomecare: Industry ‘shining’ as pressure mounts
October 19, 2021Theresa Flaherty, Managing Editor
ATLANTA – There’s an increasing amount of pressure on CMS to finalize a DMEPOS proposed rule that would adjust payment rates for HME, AAHomecare’s Tom Ryan said in an update at Medtrade East on Tuesday morning.
A letter asking CMS to act on the rule, published a year ago, garnered 95 signatures last week from members of the House of Representatives, including champions on the influential Ways and Means and Energy and Commerce committees.
“That’s in the hands of...
DMEPOS proposed rule is on the move
October 19, 2021HME News Staff
WASHINGTON – CMS has sent the DMEPOS proposed rule to the Office of Management and Budget for final review, AAHomecare reports.
A letter asking CMS to act on the rule, published a year ago, garnered 95 signatures last week from members of the House of Representatives, including champions on the influential Ways and Means and Energy and Commerce committees.
“Capitol Hill is starting to understand the market realities and new operational environment that suppliers...
Letter pushes for finalizing DMEPOS proposed rule
September 29, 2021HME News Staff
WASHINGTON – Reps. Cathy McMorris Rodgers, R-Wash., and Paul Tonko, D-N.Y., are collecting signatures for a letter asking the Department of Health and Human Services and CMS to finalize a DMEPOS proposed rule that would adjust the payment amounts in non-competitive bidding areas.
The proposed rule would also extend 50/50 blended reimbursement rates in rural/non-contiguous areas.
“We appreciate HHS’s and CMS’s efforts to make changes to Medicare policy...
AAH comments on rates
December 29, 2020HME News Staff
WASHINGTON – Rates in former competitive bidding areas should be based on a 90/10 blended payment formula, AAHomecare argues in its comments to CMS’s recent DMEPOS Proposed Rule.
“The 90% should be based on the current payment rates in former CBAs, and the 10% should be based on the 2015 unadjusted fee schedule,” the association says.
Non-rural, non-CBAs should be based on a 75/25 blended payment formula, with the 75% based on the current rates...
CMS publishes jam-packed proposed rule
October 27, 2020HME News Staff
WASHINGTON - CMS seeks to continue paying higher payment amounts to suppliers in non-competitive bidding areas as part of a DMEPOS proposed rule that it published on Tuesday afternoon.
The agency also seeks to: permanently exempt manual wheelchairs and accessories from the bid program; classify all continuous glucose monitors, not just therapeutic CGMs, as DME and establish payment amounts for them and their related supplies and accessories; and expand the classification of external infusion pumps...
CMS moves to solidify telehealth
August 4, 2020HME News Staff
WASHINGTON - CMS is proposing changes to expand telehealth permanently, following President Trump's signing of the “Executive Order on Improving Rural and Telehealth Access” on Aug. 3.
In a 2021 Physician Fee Schedule proposed rule, CMS takes steps to extend the availability of certain telemedicine services after the public health emergency ends, giving Medicare beneficiaries more convenient ways to access health care, particularly in rural areas where access to providers...
CMS makes first move to permanently incorporate telehealth into care
June 30, 2020HME News Staff
WASHINGTON - CMS is proposing to allow home health agencies to continue to report the costs of telehealth as allowable administrative costs on line 5 of the home health agency cost report, according to a proposed rule. The agency proposes modifying the instructions regarding line 5 to reflect broader use of telecommunications technology. Additionally, CMS proposes to include not only remote patient monitoring but also other communications or monitoring services, consistent with the plan of care for...