CMS Releases More Details on CURES Act Implementation

CMS provides update on additional six-month delay of bid expansion pricing, other elements of newly approved law.

• By David Kopf
• Jan 05, 2017

CMS has updated its Durable Medical Equipment Center page with information the 21st Century CURES act, which the 114th Congress passed and President Obama signed into law.

The main fact that the updates recognize is that the CURES Act provides retroactive relief to non-bid providers by extending the initial phase of partial reimbursement cuts to impacted items. That phase-in original ended on June 30, 2016, but the CURES Act pushed that a Dec. 31, 2016 end date.

Per section 16007 of the law, CMS must reimburse claims made after July 1, 2016 and before Jan. 1, 2017 with the difference between the full reimbursement cuts and the partial, phase-in rate.

In the updates to the DME Center page, CMS said it is “currently working to implement this section [16007] and will be providing contractor instructions for re-processing the applicable claims.” The agency added that suppliers aren’t required to take any action for the moment.

The update also acknowledged that section 16005 of the Act delays the application of competitive bidding-derived reimbursement cuts to accessories for Group 3 complex rehab mobility devices another 12 months until July 1, 2017. (A previous 12-month extension had previously been secured in December 2015.)

CMS’s update stated that to implement the extension, it updated the 2016 KU fee schedule amounts by the 2017 0.7 percent covered item update, which will be added to the 2017 DMEPOS fee schedule file. The agency instructed providers to continue using the KU modifier when billing for wheelchair accessories and seat and back cushions furnished in connection with Group 3 complex rehab power wheelchairs with dates of service Jan. 1 through June 30.