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Legislation Introduced Addressing Rural Reimbursement Concerns And Budget Neutrality For Oxygen

Long-awaited legislation was introduced today addressing DME reimbursement concerns in non-competitive bidding areas (areas CMS labels at rural and non-rural). Past competitive bidding programs have driven reimbursement rates to unsustainable levels, making it difficult for suppliers to provide quality care to their patients. This program has resulted in providers forced to maintain care levels with half of the resources. These cuts have made it especially difficult on rural providers and have threatened access to care for patients in rural America. Protecting Home Oxygen & Medical Equipment Act of 2019 was introduced today by champion congressional leaders Reps. Cathy McMorris Rodgers (R-Wash.) and Dave Loebsack (D-Iowa). DME suppliers that serve patients in rural areas of the country have been waiting for this legislation to be introduced since the beginning of the year. Click here to review the bill. This bill will… 1. Create a new payment methodology in non-competitive bid areas.
  • For DME suppliers servicing patients that reside in areas CMS indicates as RURAL, suppliers will see an increase of the “50/50 blended rate.-
  • For DME suppliers servicing patients that reside in areas CMS indicates as NON-RURAL, 75% of the adjusted payment amount and 25% of the unadjusted will be applied.
2. Budget Neutrality for Oxygen - In 2017, CMS incorrectly applied a budget neutral “offset- to 2017 rural fee schedules for oxygen concentrators. This led to an improper reduction in reimbursement for HCPCS E1390 by an additional 11 percent on average. This forced reimbursement rates in rural areas below the average regional competitive bidding special payment amounts (SPA). This legislation addresses the outdated budget neutrality regulation which “double dips- oxygen reimbursements, reducing them by an average of 11 percent. Past legislative efforts to increase DME reimbursement and change payment methodology gained strong congressional support, but fell short prior to the end of the year. We need the support of past congressional leaders as well as new supporters. We've made it easy for you to message your congressional leaders! Simply click here to send an email message to your representative today. Members of Congress need to hear from many in order to take action and sign on to a bill. Please encourage all of your coworkers and friends to do the same. We will continue to update you as the bill gain supporters.

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