Category Posts

Yesterday, medical equipment suppliers in Kentucky and Tennessee attended a virtual meeting discussing the tornados that ripped through Kentucky and Tennessee in December. The meeting was assembled by Tangita Daramola, Competitive Acquisition Ombudsman, and the VGM Government Relations team.  

 

Suppliers from Kentucky and Tennessee were able to voice their concerns regarding needs and difficulties during the December tornados with representatives from FEMA,...

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Listen below as Ronda Buhrmester breaks down the new prior auth list, requirements, and the phases to implementation. 

Click here for the update master list of items subject to face-to-face and WOPD and/or prior auths.

And register for Ronda’s upcoming Live Chat, Wednesday, January 20th at 11am central as she covers PHE waivers, and disects the new master list. Register for her Live Chat! Seats are limited!

 

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When is it a good time to review the product and services your business offers? Now is the perfect time. CMS released an update stating that beginning January 3, 2022, DMEPOS suppliers will receive informational messaging on the remit resulting in a claim denial when the supplier is not appropriately accredited. In addition to reviewing accreditation information, you should also review the products and services offered on the 855S application or within PECOS.

The MLN article...

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While it is true that our industry, and all industries for that matter, face challenges on several fronts, we should take stock in the amazing service, support, and products that our community was able to provide to those in need! Your focus on the patient was never more needed, and each of you rose to the challenge. As you battle through supply shortages, uncertain healthcare policies, public health emergencies, and crazy weather in multiple regions across the county, you continue to...

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Compiled by Mark J. Higley, Vice President of Regulatory Affairs

As we begin 2022 and look back on 2021, we recognize the challenges over the past two years by the COVID-19 pandemic and its effect on the DMEPOS industry. Coupled with supply chain issues, product recalls and surcharges, demanding demographic changes, and the uncertainty attributable to the reimbursement direction from the industry’s biggest payor (Medicare), it is perhaps somewhat remarkable that our businesses...

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Watch this latest vlog from Ronda Buhrmester, Sr. Director of Payer Relations, as she walks through how to find the CMS DMEPOS fee schedules and more!

Long awaited with keen interest by industry stakeholders, CMS released on December 21, 2021 its final rule (CMS-1738-F) relative to post-pandemic DMEPOS fee schedule adjustments, in addition to making certain benefit category and payment determinations for new items, classification of adjunctive continuous glucose monitors as DME under Medicare Part B and finalized certain DME payment provisions that were included in two interim final rules (CMS-1687-F and CMS-5531-F).

However, the main...

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President Biden Signs Legislation Averting PAYGO and Sequester Cuts from Taking Effect at the Beginning of 2022 

Late last week, President Biden sign S.610, the “Protecting Medicare and American Farmers from Sequester Cuts Act,” which delays implementation of the additional 4% reduction in reimbursement for Medicare providers and suppliers (PAYGO) as well as the 2% reduction in Medicare sequestration cuts. This includes:

No payment adjustment through...

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Yesterday, December 2, CMS announced that the 2022 DMEPOS fee schedule increase is 5.1 percent for non-competitive bid items, 5% for competitive bid items in the 130 “former” CBAs, and 5.4% for competitive bid items in non-CBAs. This is larger than any annual Medicare increase in the last 30 years. You may reference the Calendar Year 2022 Update for DMEPOS Fee Schedule (Change Request 12521) for additional detail here.

The effective date (date of service) is...

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November 13th CMS announced that Medicare Part B premiums and deductibles will see the largest hike in the program's history next year.

Seven issues of concern…

The CMS rule boosts the standard Medicare Part B premium to $170.10 a month, up $21.60, or 14.5 percent. It also increased Part B standard deductibles by $30, up 14.8 percent to $233 in 2022
  The increase translates to nearly $14,000 in annual costs for the wealthiest senior couples.
  Despite...

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