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CMS to Delay Enforcement of Some DME Requirements — but Not Bidding

Friday, July 12, 2013   (0 Comments)
Posted by: Becky Dryden
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June 27, 2013 –3:55 p.m.
CMS to Delay Enforcement of Some DME Requirements — but Not Bidding
By CQ Staff

Durable medical equipment suppliers and providers have been urging federal officials to take it slow when it comes to some new health care law requirements that affect that industry. On Thursday, Centers for Medicare and Medicaid officials agreed to postpone enforcement of one new rule, but not the most controversial one — DME bidding.

"Due to concerns that some providers and suppliers may need additional time to establish operational protocols necessary to comply with face-to-face encounter requirements mandated by the Affordable Care Act for certain items of DME, the Centers for Medicare & Medicaid Services (CMS) will start actively enforcing and will expect full compliance with the DME face-to-face requirements beginning on October 1, 2013," CMS officials said Thursday in a memo to congressional health staffers obtained by HealthBeat.

The provision in question, the memo says, requires a doctor to document that a physician, nurse practitioner, physician assistant or clinical nurse specialist has had a face-to-face encounter with the patient before ordering certain medical equipment. And that encounter must occur within six months before the order is written for the DME.

"We note that this new requirement does not affect the implementation of Round 2 of the DME competitive bidding program which is set to start on July 1, 2013 in the Round 2 competitive bidding areas," the memo said.

The implementation of competitive bidding, designed to save money on wheelchairs and other medical equipment, has been controversial from the start. DME suppliers have been opposing it, and two weeks ago 227 House members — Republicans and Democrats — signed a letter to CMS Administrator Marilyn Tavenner urging her to delay until the end of the year expansion of the competitive-bidding program (see related story, CQ HealthBeat, June 13, 2013).

At the time, CMS officials said they did not plan to delay, and Thursday’s memo to House staffers reiterates that decision.

• From CQ Hot Docs: CMS memo (pdf)

John Reichard contributed to this report.

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