single payment amounts, which used Round 2021’s lead item pricing methodology. The agency said it made contract offers in 127 CBAs for the two categories and expects to save $600 million over the three-year Round 2021 contract period.
The full announcement from CMS can be read here. An update from CBIC can be read here.
More Questions Than Answers
The prevailing issues that CMS’s statement did not make clear is how reimbursement for the 13 categories CMS opted not to compete will work and will current rates still apply?
The last competitive bidding contracts expired Dec. 31, 2018, and since then, the program has been dormant, with any qualified DMEPOS supplier serving Medicare beneficiaries. While most in the industry expected that gap to exist for a maximum of 24 months, it appears — at least for the moment — that gap presumably has no foreseeable end with CMS’s latest Round 2021 announcement.
While the industry’s legal, reimbursement and government relations experts seek clarity on what happens next after analyzing a 210-page proposed rule that accompanied the Round 2021 announcement, some initial reaction came in:
“HHS and CMS are making the right call here,” noted Tom Ryan, president and CEO of the American Association for Homecare, in a public statement. “Removing the majority of HME product categories from Round 2021 will allow suppliers to effectively serve their communities as the public health emergency continues, and also provide care for individuals with long-term healthcare challenges as they recover from COVID-19.
“Once we’re clear of this pandemic, policymakers, HME stakeholders, clinician organizations, and patient groups should take advantage of the opportunity to develop a new system for Medicare reimbursements,” he added. “It’s time to move on to a better approach that expands access to HME as the patient population that depends on these products and services continues to grow.”
100% nailed by @TomRyanHME@aahomecare
“These products have been bid multiple times, and we’ve found a payment floor. Competitive bidding should end for these products permanently.”https://t.co/yJRdTWNIfa
— Gary Sheehan ???????? (@gmsheehan) October 28, 2020
Thank you @CMSgov for protecting access to home respiratory care by excluding home oxygen supplies and equipment from Round 2021 of the Competitive Bidding Program! https://t.co/rsHindvxfR
— Council for Quality Respiratory Care (@TheCQRC) October 28, 2020
“We feel our concerns are being heard, but there is still work to be done,” said Clint Geffert, president of VGM & Associates. “We will continue to work with stakeholders and put pressure on CMS to ensure fairness for our industry.”https://t.co/wlYgDkDOvY pic.twitter.com/jjkONeqjoi
— VGM Gov’t Relations (@VGMGovRelations) October 28, 2020