In early October, the Centers for Medicare & Medicaid Services (CMS) released new data which provides a wealth of information related to durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) provided to Medicare beneficiaries via referrals from physicians and other health care professionals. The 2013 data set is called, “The Referring Provider Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Public Use File” and is part of CMS’s Medicare Provider Utilization and Payment Data set. The new data includes information on 385,915 referring providers, more than 100 million claims and $11 billion in Medicare allowed payments for calendar year 2013. The data is posted on the CMS website at cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-provider-charge-data/dme.html. The data set identifies individual providers who referred DMEPOS items and services using their National…
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:…
In addition to changing rates in non-bid locations, CMS plans to lower certain rates based on regional calculations, all under the guise of streamlining the bid program