CMS is seeking comments on an interim final rule that increases payments to suppliers for some DME and enteral nutrition in areas of the country that are not subject to the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DEMPOS) Competitive Bidding Process (CBP). These include rural areas, and Alaska, Hawaii and the territories. From June 1 through December 31, 2018, payments will return to the blended rates that were in effect in 2016.
The change is in response to stakeholder concerns about significant financial challenges created by the current rates for suppliers, as well as concerns that the number of suppliers in certain areas continues to decline. It is projected to result in a $70 million dollar Medicare cost-sharing increase to beneficiaries. This increase may be covered by supplemental insurance programs like Medigap, and for dual eligible beneficiaries, Medicaid pays the cost sharing. However, beneficiaries who do not have supplemental insurance or who are not dual eligible will have increased cost sharing.
For more information on Durable Medical Equipment Fee Schedule, Adjustments to Resume the Transitional 50/50 Blended Rates to Provide Relief in Rural Areas and Non-Contiguous Areas (CMS-1687-IFC) or to submit a comment on or before July 9, 2018, please visit Regulations.gov.