CMS Increases Payments for Durable Medical Equipment

The U.S. Centers for Medicare and Medicaid Services (CMS) has issued an interim final rule raising Medicare payments for durable medical equipment (DME) to ensure beneficiaries have access to critical medical devices, reports HealthPayerIntelligence . These payments will be increased from June 1, 2018, to Dec. 31, 2018, within rural areas not subject to the DME Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP). The agency calculates that Medicare will pay an additional $290 million in benefit payments and $70 million in beneficiary cost sharing for DME services during the six-month interval. CMS says many small DME providers and businesses undergo financial challenges under current DME payments rates, and raising them would ensure that these businesses can maintain financial stability and provide beneficiaries with devices. Last year and the year before, the DMEPOS CBP adjusted payment rates for devices such as oxygen tanks and enteral nutrition systems in rural regions catalogued as "non-bid" areas. These areas experienced adjusted payment rates that were 50 percent lower than unadjusted rates in parts of the country participating in the DMEPOS CBP. DME providers in rural areas will now receive "blended rates" that are calculated by combining half of DMEPOS CBP rates and half of the traditional fee-for-service payment rates. "Going forward, CMS will continue to review data and information about rates for DMEPOS items and services," the agency says. "CMS intends to undertake subsequent notice-and-comment rulemaking to address the rates for durable medical equipment and enteral nutrition furnished in 2019 and beyond."