Tag: Bundled Payments

WASHINGTON - A bipartisan group in the House of Representatives is circulating a congressional sign-on letter that asks CMS to delay a CPAP bundling pilot program from the next round of competitive bidding.The letter states a number reasons for delaying the program, including the lack of evidence that it will save money or enhance care, and CMS's lack of authorization to test alternative payment models as part of its competitive bidding program.“Instead, we encourage the agency to work with...

LAS VEGAS - CMS's plan to use bundled payments isn't popular, but the initiative could, ultimately, help HME providers show their worth as cost-savers, says Emmet Seibels, who spoke at Medtrade Spring last week.“DME gets seen as a cost,” said Seibel, president of Verus Healthcare, a healthcare supply company based in Franklin, Tenn. “DME produces great results. We need to flip the perception of DME from a cost center.”CMS in October released a final rule detailing its plans...

WASHINGTON - Industry stakeholders are seeking answers to a laundry list of questions regarding CMS's “incredibly vague” plan to bundle payments for standard power wheelchairs and CPAP. “We've posed several questions already and will submit about a dozen more,” said Kim Brummett, senior director of regulatory affairs for AAHomecare. “CMS has indicated they are compiling the questions and will respond to the industry. CMS knows the bundling thing is incredibly...

WASHINGTON - HME stakeholders are deeply concerned about CMS's plan to bundle payments for power wheelchairs and the impact that will have on patients and providers' bottom lines. In a final rule issued Oct. 31, CMS stated that it would implement a demo project in 12 competitive bid areas, in which providers would submit a single bid for furnishing standard power wheelchairs, related accessories and services needed on a monthly basis. Bundling is not an unreasonable concept, but CMS'...

WASHINGTON - CMS plans to move forward with its plans to implement competitive bid pricing nationwide, despite widespread opposition from the HME industry. “This is a big deal,” said Kim Brummett, senior director of regulatory affairs for AAHomecare. The agency issued its final rule Oct. 31. The proposed rule was published in July. The biggest concern: the application of bid rates in non-competitive bidding areas (CBAs), beginning Jan. 1, 2016 and phased-in over a six-month time...

Dear Ms. Tavenner: I write this letter based on my experience as the executive director of the American Sleep Apnea Association from May 2004 to March 2014. The opinions and recommendations expressed here are my own and not those held by the association.During my tenure at the association, significant changes have come about in health care, in general, and for obstructive sleep apnea (OSA) in particular. The decision to allow for physician payment for prescription of positive airway pressure (PAP)...

WASHINGTON - Industry stakeholders say a large number of providers answered the call to submit comments by Sept. 2 on a proposed rule to, among other things, expand the competitive bidding program nationwide.More than 4,000 comments were submitted on the overall rule, and stakeholders believe a good number of them pertained to the bid expansion and another HME provision to create bundled monthly payments.“The feedback we've gotten from providers spoke to rural healthcare access,” said...

WASHINGTON - CMS should scrap its plans to expand competitive bidding nationwide and to implement bundled payments, AAHomecare stated in comments submitted to the agency on Sept. 2. CMS is proposing applying competitive bidding prices in non-bid areas by using regional prices limited by a national ceiling (110% of the average of regional prices) and a floor (90% of the average of regional prices). “The top line recommendation to CMS reiterated AAHomecare's position that single...

YARMOUTH, Maine - Mobility providers aren't lining up to support a CMS proposal to describe, and pay for, standard manual and standard power wheelchairs each under a single code. Ninety-five percent of the 98 respondents to a recent HME NewsPoll say they don't like the plan. There are too many differences between wheelchairs—combining them under a single code would encourage the use of cheap products with few options, they say.“There are too many variations based on the individual...

WASHINGTON - The devil's in the details, and the lack of details in CMS's proposal to implement bundled monthly payments for standard manual and power wheelchairs has stakeholders on edge.“There are so many more questions that this proposal raises than it answers, and that should probably be more troubling than anything else,” said Cara Bachenheimer, senior vice president of government relations for Invacare.CMS states in a proposed rule published in the Federal Register on July 11: “We...