Bill Popomaronis, R.Ph., NCPA vice president, home health and long term care pharmacy services, provides his thoughts and explanations on the latest DME information from CMS.
Wednesday, June 25, 2008
DuoNeb Local Coverage Determination Delayed
The nebulizers local coverage determination, effective for dates of service on or after July 1, 2008, is being revised. The implementation of least costly alternative to the FDA-approved unit dose combination of albuterol sulfate and ipratropium bromide (DuoNeb - J7620) is delayed and will become effective for claims with dates of service on or after November 1, 2008. Suppliers should become familiar with the new Nebulizers Policy prior to its effective date to minimize effects on their billing process.
Thursday, June 19, 2008
Why Delay Competitive Bidding?
In a recent statement, Senate Finance Committee Chairman Max Baucus (D-Mont.) proved he "gets it" when it comes to delaying the start of Medicare competitive bidding.
“Durable medical equipment can give seniors the freedom to live at home, and so it’s important to maintain a reliable system in Medicare to provide these vital items," Baucus said. "I am supportive of competitive bidding as a means of reducing cost, but that cannot be accomplished at the expense of low quality and inconsistent care. The competitive bidding program for durable medical equipment should stay on hold until it’s certain that seniors will get the products they need in a way that works for them.”
“Durable medical equipment can give seniors the freedom to live at home, and so it’s important to maintain a reliable system in Medicare to provide these vital items," Baucus said. "I am supportive of competitive bidding as a means of reducing cost, but that cannot be accomplished at the expense of low quality and inconsistent care. The competitive bidding program for durable medical equipment should stay on hold until it’s certain that seniors will get the products they need in a way that works for them.”
Thursday, June 12, 2008
It Seems Like Everybody is Suing CMS
Citing faulty implementation of Medicare’s competitive bidding program for durable medical equipment, prosthetics, and supplies (DMEPOS), the American Association for Homecare filed a federal lawsuit on June 9 seeking to stop the controversial bidding program.
The program affects medical equipment and services used by Medicare beneficiaries in the home including oxygen therapy, hospital beds, and power wheelchairs.
The complaint names as defendants U.S. Department of Health and Human Services (HHS) Secretary Michael Leavitt and Centers for Medicare and Medicaid Services (CMS) Acting Administrator Kerry Weems.
The program affects medical equipment and services used by Medicare beneficiaries in the home including oxygen therapy, hospital beds, and power wheelchairs.
The complaint names as defendants U.S. Department of Health and Human Services (HHS) Secretary Michael Leavitt and Centers for Medicare and Medicaid Services (CMS) Acting Administrator Kerry Weems.
Tuesday, June 3, 2008
Tip Sheets for Grandfathering DMEPOS Suppliers and Referral Agents
Recently, CMS posted two new tip sheets related to competitive bidding, one on grandfathering and another for referral agents. Both tip sheets can be found on the CMS competitive bidding website at www.cms.hhs.gov/DMEPOScompetitivebid. Click on the "Provider Educational Products and Resources" tab and scroll down to the “Downloads” section.
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