On January 11, CMS announced that they would publish a proposed rule via the Federal Register to implement the provisions of Section 1834(h) of the Social Security Act titled Payment for Prosthetic Devices and Orthotics and Prosthetics.
The proposed rule would do the following:
The proposed rule would do the following:
- Establish requirements for practitioners and suppliers to furnish and fabricate prosthetics and custom-fabricated orthotics.
- Mandate that qualified suppliers meet certain accreditation requirements to bill for prosthetics and custom-fabricated orthotics.
- Designate a timeframe by which practitioners and suppliers must comply with the new requirements.
- Remove current exemptions from both quality standards and accreditation for certain practitioners and suppliers who furnish or fabricate prosthetics and custom-fabricated orthotics.
- Grant the authority for CMS to revoke Medicare enrollment for DMEPOS suppliers who bill claims for items that do not meet the agreed-upon requirements.
The American Orthotic & Prosthetic Association (AOPA) released a statement indicating the CMS proposed provisions are at face value in alignment with what AOPA has historically supported. Further analysis of the proposed rule is underway and AOPA acknowledged there will inevitably be areas of the proposed rule that “will require revisions, edits and improvements.”
CMS has asked for comments on these proposed changes and has given a 60-day window for comment submission. In order to be considered, comments must refer to file code CMS-6012-P and must be received no later than 5 PM on March 13, 2017. Details on how to submit comments are spelled out in the proposed rule.
This recent development on the O&P front is just one of many changes impacting DME in 2017. To help suppliers anticipate and get ready for the most relevant changes, we are partnering with HME News to bring you our signature yearly look ahead event. Industry experts Andrea Stark of MiraVista and Jeff Baird of Brown & Fortunato will discuss the challenges and opportunities facing in the DME industry in the coming year. Join us Thursday, February 9, for a 2017 Look Ahead Event for DME Suppliers. Register today to participate in this timely conversation.
CMS has asked for comments on these proposed changes and has given a 60-day window for comment submission. In order to be considered, comments must refer to file code CMS-6012-P and must be received no later than 5 PM on March 13, 2017. Details on how to submit comments are spelled out in the proposed rule.
This recent development on the O&P front is just one of many changes impacting DME in 2017. To help suppliers anticipate and get ready for the most relevant changes, we are partnering with HME News to bring you our signature yearly look ahead event. Industry experts Andrea Stark of MiraVista and Jeff Baird of Brown & Fortunato will discuss the challenges and opportunities facing in the DME industry in the coming year. Join us Thursday, February 9, for a 2017 Look Ahead Event for DME Suppliers. Register today to participate in this timely conversation.