CMS IFR Streamlines DMEPOS Regulations

In response to COVID-19, CMS’s new Interim Final Rule incorporates several relief provisions that industry advocates requested to help providers better care for patients during the pandemic, but does not include a Round 2021 delay.

CMS has released an Interim Final Rule (IFR) that covers various healthcare issues related to COVID-19 includes policy recommendations that industry advocates such as the American Association for Homecare have been pressing the Centers to implement.

While the IFR provides several pieces of DMEPOS relief, it does not include the one-year delay for implementation of Round 2021 of competitive bidding that had topped the industry’s list.

DMEPOS provisions in the IFR:

1. CMS won’t enforce clinical indications for coverage for respiratory, home anticoagulation management and infusion pump National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs), including articles. CMS will resume enforcement of these clinical indications for coverage once the COVID-19 emergency has ended.

The LCDs and NCDs include:

  • NCD 240.2 Home Oxygen. NCD 240.4 Continuous Positive Airway Pressure for Obstructive Sleep Apnea.
  • LCD L33800 Respiratory Assist Devices (ventilators for home use).
  • NCD 240.5 Intrapulmonary Percussive Ventilator.
  • LCD L33797 Oxygen and Oxygen Equipment (for home use).
  • NCD 190.11 Home Prothrombin Time/International Normalized Ratio (PT/INR) Monitoring for Anticoagulation Management.
  • NCD 280.14 Infusion Pumps.
  • LCD L33794 External Infusion Pumps.

2. Face-to-face exams are not required for items that otherwise require them due to NCD or LCD. This does not apply to power mobility devices (PMDs), but telehealth is already allowed to be used to meet the face-to-face requirements of PMDs.

3. The rule ensures that Medicare and Medicaid regulations are the same in terms of who can order medical supplies, equipment, and appliances.

4. Advance payments are available for Part B providers. 

AAHomecare highlighted that CMS had commented in the IFR that, “During the [public health emergency] for the COVID-19 pandemic, it is possible that patients receiving services for respiratory related indications will be required to receive care in unexpected settings, including the home. This may be necessary as COVID-19 and other patients are shifted across healthcare settings to accommodate an increase in patient volume.”

The IFR regulations are applicable starting March 1, and immediately effective. HME providers can submit comments during a 60-day period electronically at Regulations.gov.

AAHomecare noted that together the IFR and the recently passed CARE Act offer “significant relief and streamlining of requirements” for the industry. That said, the association said it would continue pushing for additional policy changes to help the industry better serve patients during the COVID-19 pandemic.

The IFR is available as a PDF at bit.ly/2xFceIU.

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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