After legions of Medicare beneficiaries registered complaints, the Centers for Medicare & Medicaid Services has finally acknowledged that patients are having trouble getting Medicare to approve equipment repairs, and the agency says it is working to fix how it handles repairs.
CMS has released a new guidance on supplier documentation for durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) repair claims. (Read the full guidance HERE.)
A statement from the American Association for Homecare said the association is reviewing CMS’s guidance to gauge its impact. However, the upshot is clear that providers can now repair power wheelchairs and other equipment without having to locate the original medical necessity documentation that came from the equipment’s originating provider — a difficult task made even tougher by the fact that many of those providers are out of business, the association noted.
“From patient complaints to members of Congress, it has taken many voices to help CMS understand that the current state of medical equipment repair is unacceptable,” said AAHomecare President and CEO Tom Ryan. “This new guidance is a step in the right direction towards fixing the convoluted and confusing documentation requirements.”
If Medicare paid for the original equipment at the outset, medical necessity for the base equipment has already been established, according to the guidance. Contractors should only review for continued medical necessity of the item, as well as the necessity of the repair. Moreover, contractors should not work to determine if the requirements for the initial provision of the DME were met when it was originally ordered.
This new repair guidance is to be applied to all DME items owned by Medicare beneficiaries as of Nov. 4, 2014
“AAHomecare has worked hand in hand with CMS to come to a resolution on this very important issue,” said Kim Brummett, vice president of regulatory affairs for AAHomecare. “I am excited to see CMS listening and responding to industry concerns. This development is evidence of the success of collaboration.”