MedPAC Proposes Additional HME Cuts

Reimbursement reductions part of $230 billion plan to cover doc fix.

The Medicare Payment Advisory Commission (MedPAC) has proposed a number of cuts, which impact HME providers, in order to offset the repeal of its sustainable growth rate (SGR) formula, which is used to calculate physician reimbursements from Medicare.

MedPAC’s proposal would keep primary care physicians reimbursements at their current rate by implementing $230 billion in Medicare reimbursement cuts to other healthcare billers, including HME providers. 

The cuts to HME/DME include:

  • Apply the competitive bidding offset to all competition-eligible HME categories starting in 2012. MedPAC says this would save $2 billion over five years and $2 billion over 10 years.
  • Apply the competitive bidding offset to the DME categories never subject to competitive bidding. MedPAC says this would save $3 billion over five years and $8 billion over 10 years.
  • Implement prepayment review of power wheelchairs for program integrity. MedPAC says this would save $0.1 billion over five years and and $0.2 over 10 years.
  • Additional competitive bidding reductions or fee schedule reductions to payments for home oxygen. MedPAC says this would save $3 billion over five years and $5 billion over 10 years.

MedPAC says it will decide in October if it will recommend its proposal to the Congressional super committee, which much present Congress with a budget proposal by Thanksgiving.

About the Author

David Kopf is the Publisher and Executive Editor of HME Business and DME Pharmacy magazines. Follow him on Twitter at @postacutenews.

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