WASHINGTON, D.C. – AAHomecare submitted comments to two proposed rules published by CMS last week—Calendar Year 2024 Home Health Payment Proposed Rule (CMS-1780-P) and Transitional Coverage for Emerging Technologies (TCET) pathway (CMS-3421-NC).
HHA/DMEPOS Proposed Rule
In the CY 2024 HHA/DMEPOS proposed rule, CMS proposed the following that would impact the DMEPOS industry; AAHomecare’s comments are summarized in italics:
1. Update the DMEPOS payment regulation to state that non-rural, non-CBAs will have the 75% adjusted and 25% unadjusted rates from March 6, 2020, until the duration of the PHE period or December 31, 2023, whichever is later. AAHomecare urged CMS to provide modest payment relief and modify the current Medicare payment methodology for non-rural areas and former CBAs.
2. Modify the current DME refill policy by extending the 14-day timeframe to contact the beneficiary to a 30-day timeframe. In addition, CMS requested feedback on health conditions where the requirement for contacting the beneficiary should be removed. AAHomecare fully supported CMS’ proposed changes to the provider/supplier enrollment requirements.
3. Require a provisional period of enhanced oversight (PPEO) to last between 30 days to 1 year for certain new providers and suppliers. AAHomecare supported the extended timeframe to contact beneficiaries on refills and provided additional recommendations to reduce beneficiary and provider burden.
4. Cover lymphedema compression treatment items under a new Part B benefit category—including proposals on HCPCS codes and payment. AAHomecare supported the U.S. Medical Compression Alliance’s (USMCA’s) comments on the proposed changes.
TCET Proposed Rule
CMS proposed the Transitional Coverage for Emerging Technologies (TCET) pathway to allow faster access and coverage of new technologies for Medicare beneficiaries. The TCET pathway is a voluntary process for manufacturers to submit to CMS for expedited coverage for certain FDA-designated Breakthrough Devices.
Unfortunately, CMS’ proposed pathway and narrow scope of potential devices that might qualify for the proposed TCET process will likely not encourage or incentivize medical device manufacturers to invest in new technologies that can expand the scope of health care that can be provided in a home setting. AAHomecare recommended CMS to broaden the scope of devices that could be included in the TCET program.
Here are AAHomecare’s full comments:
- CY2024 Home Health Payment Proposed Rule (CMS-1780-P) Comments
- Transitional Coverage for Emerging Technologies (TCET) Pathway Comments
White Paper Addresses Stark Law Issues for Physicians Providing Urological Supplies
Brown and Fortunato has developed a new white paper: Physician Practices Dispensing Urological Supplies to Patients: Stark Law Issues. This educational resource was developed for AAHomecare membership to help the industry better understand the Stark Law. This resource addresses the applicability of 42 U.S.C. § 1395nn (“Stark Law”) to the practice of a physician:
- mailing urological supplies (e.g., catheters) to his/her patients and/or
- directing an employee to hand deliver urological supplies to patients in the physician’s office.
If the physician is ordering and furnishing urological supplies for which payments will be made under Medicare Part B, and if the physician is not personally providing the urological supplies, then the physician must comply with a Stark Law exception.
However, there are multiple Stark Law exceptions. See more in Physician Practices Dispensing Urological Supplies to Patients: Stark Law Issues.