The new prospective payment system proposed rule from the Centers for Medicare & Medicaid Services (CMS) is clarifying that a face-to-face examination is not always needed for replacement durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) orders. CMS also released a fact sheet on July 1, the same day as the Calendar Year 2027 Home…
Medicare Proposed Rule: Eliminate Face-to-Face Requirement for Replacement DMEPOS
DMEPOS Suppliers Lead Medicare in Improper Payment Errors: MedPAC
The error rate for DMEPOS suppliers reached 24.2%, nearly four times the overall Medicare fee-for-service improper payment rate.
Providers of durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) posted the highest improper payment rate among all Medicare provider types in fiscal 2025, with documentation failures driving the majority of errors that cost the federal program billions of dollars. The error rate for DMEPOS suppliers reached 24.2%, which was nearly four times the overall…
CMS Announces Increased Oversight of Accrediting Organizations
A new final rule and fact sheet focus on avoiding conflicts of interest between accrediting organizations and providers.
The Centers for Medicare & Medicaid Services (CMS) is strengthening its oversight of organizations that accredit Medicare durable medical equipment suppliers, including those that provide Complex Rehab Technology. A June 12 fact sheet from CMS focused on the obligations of accrediting organizations (AOs) that survey Medicare and Medicaid suppliers. In the fact sheet, CMS emphasized…
DME MACs Implement New Medicare Prior Authorization Policy
The new prior authorization policy began June 1.
CGS Administrators, the jurisdictions B and C DME MAC, has published a prior authorization reminder to home medical equipment suppliers who bill Medicare. As of June 1, exempt suppliers — defined as suppliers who didn’t opt out of the process — should have stopped submitting prior authorization requests to the DME MACs “All other suppliers…
Patient Organizations: Medicaid Interim Final Rule Will Cause Massive Coverage Loss
Advocacy groups are also concerned about documentation burdens.
Healthcare organizations — including a group of 48 nonprofit, nonpartisan patient associations — are expressing concern over the Centers for Medicare & Medicaid Services’ (CMS) interim final rule requiring “80 hours per month of qualifying activities, such as employment, participation in certain work programs, or community service, or [enrollment] in educational programs at least half…
Medicaid Interim Final Rule Spells Out Work Requirements, Exemptions
Interim rule provisions are effective July 31, 2026.
The Centers for Medicare & Medicaid Services’ (CMS) new interim final rule will implement “a new statutory requirement for certain adults in Medicaid to meet an 80-hours-per-month work requirement — sometimes referred to as Medicaid community engagement — as a condition of eligibility.” In its June 1 announcement, CMS said states “must generally implement this…
Ultralightweight Upgrade Bill Advances to Full U.S. House of Representatives
A companion bill is also in the Senate.
H.R. 1703, the Choices for Increased Mobility Act of 2025, has moved one step closer to becoming law. After advancing out of the House Energy & Commerce health subcommittee on May 13 by voice vote, the Energy & Commerce committee passed the bill unanimously, with a 45-0 vote, on May 21. The next step for…
Briefly: Numotion Adds to Leadership Team; CMS Expands New Provider Moratorium
Featuring Numotion and the Centers for Medicare & Medicaid Services.
Numotion Welcomes Chief Human Resources Officer Andrea Dedrick Numotion has added Andrea Dedrick to its leadership team. Dedrick is the national provider’s new chief human resources officer and brings more than 25 years of experience in medtech. Numotion said in describing Dedrick’s experiences, “She is recognized for enabling business growth through organizational transformation, strong leadership…
Ultralightweight Upgrade Bill Called ‘Common Sense’ at Congressional Meeting
H.R. 1703 would reduce the financial barriers for Medicare beneficiaries.
The bill that would create a more accessible path for Medicare beneficiaries wanting to upgrade their ultralightweight wheelchairs was described as “common sense” during a Jan. 8 Energy and Commerce Health subcommittee meeting. The meeting centered on several bills related to durable medical equipment and funding barriers such as competitive bidding. Tom Ryan, president/CEO of…
CMS Releases 2026 Medicare Fee Schedule Changes
Competitive bidding rounds impact the actual increases for product categories.
The new Medicare fee schedule for durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) has been released by the Centers for Medicare & Medicaid Services (CMS). The fee schedule is effective Jan. 1, 2026. CMS announced the Consumer Price Index Urban (CPI-U) percentage increase as 2.7%. But in a Dec. 22 bulletin, the American Association…