On February 26, 2014, CMS released a proposal to solicit public comment on how to apply the pricing and methodologies of the current competitive bidding programs to the remainder of the country. The proposal, located on the federal registry website, outlines the techniques being considered by CMS to adjust fee schedule payment amounts for DMEPOS items and services furnished in areas that are not included in the current competitive bidding programs. Among the considerations, CMS has explored the possible testing of a bundled payment system for certain items of DME which would completely transform the capped rental category as it is currently known. The proposal puts a few ideas on the table and reiterates CMS’s intent to move forward with its expansion of the competitive bidding program by 2016. Providers have a unique opportunity to affect the outcome of this dialogue by submitting comments electronically via regulations.gov. As of 11:59 PM on March 24th, only 13 comments have been documented as received by CMS. It is vital that providers understand what is being proposed, contemplate the impact and provide feedback to CMS.
On December 3, 2013 CMS posted a clarification on the Face-to-Face rule that rattled the DME community. The F2F rule, has effectively been divided into two major directives: 1) the requirement for a documented F2F within the six months prior to the written order, and 2) the requirement to secure a Written Order Prior to Delivery. CMS intends to enforce the Written Order Prior to Delivery for claims processed in January 2014.
Prior to the December announcement, enforcement of the Rule was delayed on two separate occasions. The first was a three month delay in the enforcement from the original July 1, 2013 start date, and the second offered an unspecified delay of enforcement through an unspecified date in 2014. However, on December 3rd, CMS came forward to indicate that only the F2F provisions were intended for delay and they never intended a delay for the WOPD requirement. Amid several remaining unanswered questions, CMS and the MACs continue to move this portion of the directive forward.