Noridian Healthcare Solutions, the Supplemental Medical Review Contractor (SMRC) for the Centers for Medicare & Medicaid Services (CMS), is conducting post-payment reviews of Medicare DME claims for intermittent urinary catheters with dates of service from Jan. 1, 2022, through Dec. 31, 2023. In its announcement, Noridian referenced a February Washington Post story, “US Investigates Alleged…
Noridian SMRC Announces Post-Payment Review of 2022-2023 Catheter Claims
ITEM Coalition Sends 75/25 Reimbursement Rate Letter to Congressional Leaders
More than 30 advocacy organizations urged Congress to improve funding rates for home medical equipment.
The ITEM Coalition has sent a letter to Congressional leaders to urge their support for the reinstatement of the Medicare 75/25 blended reimbursement rate for home medical equipment. In a Dec. 2 letter, the ITEM Coalition noted that the expiration of the 75/25 reimbursement rate in January has hurt patient access to durable medical equipment…
CMS Wants to Prevent ‘Barriers to Care’ in Medicare Advantage Programs, Add Guardrails Around AI
The Centers for Medicare & Medicaid Services announced policy changes last week.
The Centers for Medicare & Medicaid Services (CMS) is looking to further crack down on the companies that administer the privatized version of Medicare. On Nov. 26, CMS proposed new policies aimed at holding Medicare Advantage (MA) plans more accountable while removing “unnecessary barriers to care” for Medicare beneficiaries. The policies target “inappropriate” prior authorization…
Briefly: CMS Adds Inclusion Body Myositis to Seating Consideration List; Nonprofit Debuts Caregiver Website
Featuring NCART, the Centers for Medicare & Medicaid Services, and I AM ALS.
CMS Adds Inclusion Body Myositis ICD-10 Code for Seating Considerations The National Coalition for Assistive & Rehab Technology (NCART) has reported that the Centers for Medicare & Medicaid Services (CMS) has added the ICD-10 code for inclusion body myositis (G72.41) to the Group 2 and Group 4 lists for consideration for a skin protection and/or…
Nov. 6 HCPCS Public Meeting to Include Discussion on CRT Seat Elevation, Joystick Hardware
NCART and Palmetto GBA have asked the Centers for Medicare & Medicaid Services to make coding changes.
The Nov. 6-8 second biannual HCPCS public meeting includes a request to revise the Medicare reimbursement for HCPCS code E2298, defined as Complex rehabilitative power wheelchair accessory, power seat elevation system, any type.” The applicant — the National Coalition for Assistive & Rehab Technology (NCART) — is recommending that language be changed to “Complex Rehabilitative…
House’s Power Standing Coverage Determination Letter Sent to CMS with 22 Signatures
The Complex Rehab Technology industry continues to push for a Medicare coverage determination for power standing on power wheelchairs.
The “Dear Colleague” letter from members of Congress was sent to Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure with 22 signatures. In an Oct. 16 bulletin, the National Coalition for Assistive & Rehab Technology (NCART) updated stakeholders on the Complex Rehab Technology (CRT) industry’s latest effort to urge CMS to open the…
Commentary: CRT As Prevention? What a Concept!
A new report published by VGM & Associates suggests Medicare competitive bidding has run its course.
A new report, authored by Brian Leitten of Leitten Consulting and published by VGM & Associates, contends that the Centers for Medicare & Medicaid Services (CMS) has taken the wrong perspective of durable medical equipment (DME) for at least for the last two decades. The 2003 Medicare Prescription Drug, Improvement, and Modernization Act gave rise…
Early AAHomecare Survey Results Reveal Funding Cuts Are ‘Devastating’ HME
Some home medical equipment suppliers are wondering if they will be able to stay in business.
Early results of a July survey from the American Association for Homecare (AAHomecare) showed that home medical equipment (HME) businesses have been deeply wounded since the January expiration of the 75/25 funding relief rate. In a July 24 update to stakeholders, AAHomecare shared a sampling of comments from the 121 HME suppliers who took the…
DME MACs to Allow More Flexibility for MWC Home Assessments
Starting in July, “indirect” home assessments will be allowed for Medicare manual wheelchair claims.
The Durable Medical Equipment Medicare Administrative Contractors (DME MACs) have revised their home assessment requirement for manual wheelchairs provided to Medicare beneficiaries. Starting July 1, 2024, the DME MACs will allow home assessments to be “indirectly” obtained by the supplier who is providing the manual wheelchair. The DME MACs plan to remove the following from…
CMS Raises CRT Seat Elevation Medicare Allowable by $13.62
Joel Kaiser, director of the division of DMEPOS policy, responded to NCART’s recalculation request.
The Medicare allowable for seat elevation on a Complex Rehab Technology (CRT) power chair is getting a very modest increase. In a June 25 bulletin, the National Coalition for Assistive & Rehab Technology (NCART) said it had been notified that the allowable for HCPCS code E2298 — Complex rehabilitative power wheelchair accessory, power seat elevation…