Posts Tagged ‘MMA’

At the Obama administration’s request, the interim final rule on the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program went into effect April 18.

The rule—issued by the Centers for Medicare & Medicaid Services (CMS) on Jan. 16—implements provisions in section 154 of the 2008 Medicare Improvements for Patients and Providers Act (MIPPA) related to the program.

Specifically, this rule officially delays implementation of Round 1 of the DMEPOS Competitive Bidding Program until 2009 and Round 2 until 2011; requires CMS to conduct a second Round 1 competition this year; and mandates certain changes for both the Round 1 rebid and subsequent rounds of the program, including a process for feedback to suppliers regarding missing financial documentation and requiring contractors to disclose to CMS information regarding subcontracting relationships.

The Round 1 rebid includes the same items and services and will be conducted in the same areas as the 2007 Round 1 competition, with exceptions. Specifically, the Round 1 rebid excludes negative pressure wound therapy items and services, Puerto Rico, and Group 3 complex rehabilitative wheelchairs.

Suppliers previously awarded a competitive bidding contract will need to resubmit bids for consideration. However, suppliers need only submit financial documents from the past year, rather than the past three years.

The Round 1 rebid will occur in the following cities:

• Cincinnati, Middletown
• Cleveland, Elyria, Mentor
• Charlotte, Gastonia, Concord
• Dallas, Fort Worth, Arlington
• Kansas City
• Miami, Fort Lauderdale, Miami Beach
• Orlando
• Pittsburgh
• Riverside, San Bernardino, Ontario

The Round 1 rebid will include the following categories of items and services:

• Oxygen supplies and equipment
• Standard power wheelchairs, scooter and related accessories
• Complex rehabilitative poser wheelchairs and related accessories
• Mail-order diabetic supplies
• Enteral nutrients, equipment and supplies
• Continuous positive airway pressure (CPAPA), respiratory assist devices (RAD), and related supplies and accessories
• Walkers and related accessories
• Hospital beds and related accessories
• Support surfaces (Group 2 mattresses and overlays) in Miami

CMS is expected to issue guidance on the timeline and bidding requirements related to the Round 1 rebid in the upcoming weeks. This rule does not have an immediate effect on the DMEPOS benefit for Medicare beneficiaries.

The Centers for Medicare & Medicaid Services (CMS) announced Feb. 6 that the permanent Recovery Audit Contractor (RAC) program is set to begin March 1. The bidding protests filed by Viant, Inc. and PRG Schultz, USA, Inc., which caused a Stop Work order in October 2008, are resolved.

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The U.S. House of Representatives on Jan. 6 voted 242-181 in favor of the 111th Congress adopting the operating rules of the 110th Congress — with a few changes. In particular, the rules package (H Res 5) eliminates the Medicare “trigger” provision of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. The move frees President Obama from submitting a plan to contain Medicare costs.

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The Centers for Medicare & Medicaid Services (CMS) announced Jan. 7 it has awarded five Medicare Administrative Contractor (MAC) contracts for the combined administration of Part A and Part B Medicare fee-for-service (FFS) claims.

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Although health spending in the United States slowed to 6.1 percent in 2007 compared to 6.7 percent in 2006, according to the Centers for Medicare & Medicaid Services (CMS), it continues to shadow overall economic growth, which grew 4.8 percent in 2007.

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The Medicare Improvements for Patients and Providers Act (MIPPA) of 2008 amends the Social Security Act §1834(l)(13) and provides an increase in payment for ambulance ground transports.

Effective for claims with dates of service on or after July 1, 2008, and before Jan. 1, 2010, ambulance fee schedule amounts for covered ground ambulance transports which originate in a rural area increase by 3 percent, and covered ground ambulance transports which originate in a non-rural area increase by 2 percent.

For further details, read Transmittal 414, CR 6206 on CMS’s Web site.