Healthcare stakeholders are applauding the Aug. 27 ending of Medicare’s new home medical equipment supplier enrollment moratorium — but also tempering that approval by noting that work to effectively curb fraud and abuse should not impact patient access to care.
The Centers for Medicare & Medicaid Services (CMS) announced the six-month moratorium was expiring on time — a move that also supports the revival of the Medicare competitive bidding’s program Round 2028.
“The Council for Quality Respiratory Care (CQRC) commends the Centers for Medicare & Medicaid Services’ decision to allow the six-month moratorium announced in February on certain DME [durable medical equipment] providers, including respiratory care suppliers, to expire as scheduled,” the organization said in an Aug. 27 announcement. “CQRC applauds the administration’s efforts for prioritizing program integrity in the Medicare program and supports the expiration of the moratorium to enable more patients to access care and good-faith providers to deliver quality services and supplies.”
At the same time, the CQRC noted that respiratory reforms remain much needed.
“CQRC supports CMS’s goals to strengthen the program integrity of Medicare’s home oxygen benefit and efforts to root out fraud, waste and abuse,” the organization added. “As outlined in the CQRC’s response to CMS’s Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH) request for information, the adoption of the standardized electronic clinical data elements already developed by CMS would safeguard patients, suppliers and providers ordering claims. Incorporating the electronic template would help prevent fraudulent billing by creating clear clinical verification standards and improving the efficiency and accuracy of oxygen ordering, helping to effectively identify suspicious claims and providers while focusing resources on actual fraud and abuse.”
Medtech association AdvaMed also welcomed the end of the moratorium. AdvaMed President/CEO Scott Whitaker said in an Aug. 27 statement, “This is good news for medtech innovators and the patients they serve. We support CMS’s efforts to combat fraud, waste and abuse and protect taxpayer dollars for the care patients truly need. We appreciate CMS’s work with us over the past six months to ensure that the policies going forward will effectively root out bad actors without decreasing Medicare beneficiaries’ access to the medical technologies and equipment they rely on.”
Legal firm McDermott Will & Schulte, in making its Aug. 27 announcement of the moratorium’s end, said, “In announcing the expiration of the moratorium, CMS encouraged suppliers planning to participate in Round 2028 of the DMEPOS Competitive Bidding Program to submit completed enrollment applications to the applicable contractor as soon as possible to allow sufficient processing time prior to the opening of the bidding window. Suppliers should anticipate potential delays as the Medicare contractors process what is likely to be a high volume of applications following the moratorium’s expiration.”
The American Orthotic & Prosthetic Association and VGM & Associates were among other organizations confirming the end of the moratorium.
The Ohio Association of Medical Equipment Services (OAMES) posted an alert from the American Association for Homecare (AAHomecare) and AAHomecare President/CEO Tom Ryan that said, “We appreciate CMS’ decision to let this moratorium run its course rather than extend it further. We raised this issue directly with [CMS Administrator] Dr. [Mehmet] Oz, [CMS Deputy Administrator] Kim Brandt, and the White House, so it’s good to see that translate into action.
“But let’s be clear; the industry isn’t looking for less scrutiny of fraud, waste and abuse. Technology-driven safeguards, like the electronic verification of physician orders the OIG [Office of the Inspector General] recommended in its recent white paper, along with tools our industry has already invested in, like ePrescribing, are the kind of protections that keep bad actors out without punishing legitimate suppliers. With the moratorium lifted, established suppliers can move forward as they prepare for the next round of competitive bidding under the new remote item delivery requirements. We’ll keep working with CMS to build on this progress with smarter, technology-based solutions rather than broad enrollment freezes.”
