CMS rejected a proposal to increase home infusions

CMS rejected a proposal to increase home infusions

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The Center for Medicare and Medicaid Services will not be finalized in 2020 proposal By covering external infusion pumps, Medicare beneficiaries can get more medicines through home infusion, the agency Announce In the final rules announced on Tuesday.

The rules also clearly stipulate that suppliers of durable medical equipment will continue to receive higher reimbursements for goods and services provided in rural areas.

According to the current final policy, medical equipment Suppliers in rural areas, Alaska, Hawaii and the Territory will continue to receive half of the normal fee schedule plus half of the adjusted fee rate for rural suppliers. According to the regulation, the opinions of stakeholders indicate that there are higher costs, greater travel expenses, logistical difficulties and other challenges in providing equipment and services in rural areas.

CMS has also established temporary pricing of durable medical equipment during public health emergencies, which is through an authorization COVID-19 relief Law promulgated in March 2020.

The law requires that certain products provided in rural and non-contiguous states and territories (not competitive bidding areas) be compensated at a 50/50 blended rate throughout the entire public health emergency. Items provided in all other non-competitive bidding areas will pay 75% of the adjusted fee schedule and 25% of the unadjusted fee schedule.

In addition, the agency has also established a public opinion process on the categories of new durable equipment, prostheses, orthotics, etc., which is a necessary step to determine whether products are covered by medical insurance. Stakeholders can also comment on payments for these items.

But CMS will not come up with the idea of ??covering medically necessary external infusion pumps. According to a CMS press release, commenters on this element of the proposed rule stated that the policy was unclear and raised concerns about cost and safety.

In addition, the final rule classifies continuous blood glucose monitors as durable medical equipment under Part B of medical insurance.

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