Author
Seth Johnson
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Washington OutlookAs Congress begins to wrap up the legislative session for the year, our industry priorities are well positioned for advancement. While at press time we do not know what the final outcome will be, based on regular communications with our legislative champions we have done what they asked in order to put our priorities in the best possible position to move on a must-pass bill in early December. Efforts to apply congressional pressure on Medicare to make changes on their own have been significant from both the House and Senate. However, Medicare shows no signs of changing course unless Congress passes legislation requiring them to do so. So, absent congressional action on industry legislation, Medicare payments to providers will be cut significantly for complex rehab...
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Washington OutlookCongressional Legislation Introduced to Help Complex Rehab and Rural Providers
Congress introduced two bills to address concerns with CMS’s plans to apply competitive bid (CB) rates to statutorily exempt complex rehab technology (CRT) wheelchair accessories and to apply bid rates in non-bid areas. Absent passage of the legislation, Medicare payments to providers will be cut significantly for CRT wheelchair accessories and the DME items included in competitive bidding. Outreach and advocacy efforts with your federal legislators are needed to help strengthen support for passage of the bills. The CMS proposals were included in a Final Rule (1614-F) last November, which contains provisions relating to the DME Competitive Bidding (CB) program and how CMS plans to roll out competitive bid pricing in non-bid areas. A subsequent December Frequently Asked Questions (FAQ) document indicated that beginning in... -
Washington Outlook
Congressional Recess Provides Opportunity to Reengage
Congress is currently on its annual summer recess. This provides a great opportunity to schedule a local office meeting or, better yet, a site visit to your company to educate them on the challenges your company is having providing products/services to beneficiaries. Votes are expected on Medicare legislation throughout the fall, and priority issues include: legislation to modify CMS’s plans to apply bid rates in rural areas; legislation to stop the application of bid rates to exempt complex rehab wheelchair accessories; audit reform legislation; and separate recognition for complex rehab technology. Here is a guide to assist in your advocacy efforts. Application of Competitive Bidding Rates in Non-Bid Areas The latest industry draft of a legislative proposal to provide some relief to this application would:... -
Washington Outlook
Expand Prior Authorization Demonstration Nationally
CMS's three-year Power Mobility Device (PMD) prior authorization demonstration is scheduled to expire Sept. 1 unless CMS or Congress take action later to continue what many have indicated is a successful program. -
Washington Outlook
Application of Bid Rates
CMS looks to use these numbers for non-bid areas and exempt items -
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Washington Outlook
Competitive Bidding and Bundling Final Rule
What’s next, and can we advance a better alternative? -
Washington Outlook
One Step at a Time
More states join the PMD Prior Authorization Demonstration as progress continues -
Shelly Sez
Congressional Recess Provides Local Opportunity to Engage
A guide to assist you in advocacy efforts on priority issues -
Legislation & Regulation
Audit Relief Legislation
Potential reform is on the horizon for the DMEPOS auditing process


