Comments on Proposed ESRD/DMEPOS Rule Due Sept. 27

The proposed rule contains HME-related provisions such as changes to its ‘gap-filling’ method, payment requirements, and change of ownership timeline.

• By David Kopf
• Sep 19, 2019

The deadline for public comments on the proposed ESRD/DMEPOS rule for 2020 that CMS released in early August is coming up fast, with comments due on Sept. 27.

The proposed rule contains several provisions related to home medical equipment, including changes to its method for “gap-filling” reimbursement rates on certain DME items; payment requirements; requesting market-based data related to diabetic testing suppliers; and change of ownership (CHOW) timeline.

The complete text of the proposed rule is available at bit.ly/2LU6dy3, and a CMS fact sheet on the proposed rule is available at go.cms.gov/2YkNzWz. Also, the American Association for Homecare shared a summary of the proposed rule.

Providers can submit their comments at regulations.gov/document?D=CMS-2019-0110-0002.

AAHomecare distributed some critical points on various provisions to help providers shape their comments:

• Gap-filling — “The current Medicare gap-fill methodology is out of date, insufficient, and significantly flawed. AAHomecare strongly opposes CMS’ proposal to codify the flawed gap-filling pricing policies in federal regulation.  Instead, we urge CMS to implement a process that involves all stakeholders, including experts, and is completely transparent.”

• Payment conditions — “Overall, AAHomecare supports CMS’ proposal to create this single “Master List,” but we have a number of concerns regarding the notice, timing and transparency associated with the “Master List” and the ‘Required List.’”

• CHOW — “AAHomecare supports the proposal to extend the CHOW timeline from 60 days before the effective CHOW date to 10 days after the effective date.”

The association said it would share its final comments with its membership before the Sept. 27 due date and invited providers to submit their letters in concurrence with its commentary overview.