CMS’s Physician Final Rule Includes New DME Rules

Includes first-month purchase option elimination, oxygen payment changes for relocating patients.

p>CMS has released “Medicare Program; Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2011,” its 2011 Medicare physician final rule, which contains several key provisions for HME providers:

  • Adjusts the formula for calculating the annual update for DMEPOS items with a productivity adjustment.
  • Eliminates the first-month purchase option for standard power wheelchairs.
  • Modifies payment policy for oxygen equipment for beneficiaries who relocate their residence outside the provider’s service area.
  • Addresses transition payments for oxygen and capped rental equipment when beneficiaries change providers.
  • Adds an appeals process for contract providers terminated from the competitive bidding program.
  • Authorizes the implementation of a national mail order competition for diabetes supplies.
  • Establishes additional rules for diabetes supplies (50 percent rule and anti-switching rule).

The American Association for Homecare has hosted a PDF file of the final rule, which can be viewed at http://www.aahomecare.org/associations/3208/files/Physician%20Fee%20Rule.pdf.

About the Author

David Kopf is the Editor of HME Business.

Comments

Thu, Nov 4, 2010 Bill Dallas

We did not win a contract but did get a letter from CMS dated 11/3 stating our bids were too high. It also said I had 30 days prior to 1/1/2011 to notify our beneficiaries on grandfathering. CMS lied as we were informed by e-blast today it is 11/17, 13 days. This is typical of the intimidation, bullying, arrogant attitude CMS has towards the industry. CMS delay was a another deliberate move to stick it to us and the patients will eventually pay.

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