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Educate, Prepare and Engage Your Patients as DME Reimbursement Cuts Near

Posted on in HME Government Issues

On Nov. 23, CMS released their 2016 DMEPOS fee schedule. We knew there would be significant reimbursement cuts to equipment, specifically complex rehab accessories, but after close analysis by advocacy partners, we have concluded that the cuts are much worse than we thought.  The new payment rates include major reductions to complex rehab wheelchair accessories, as high as 30% to 40%.

“The recent publication of the 2016 Medicare fee schedule presents major access problems for people with disabilities who rely on complex wheelchairs.  In spite of Congressional letters and conversations, CMS is inappropriately applying Competitive Bid pricing and implementing drastic payment reductions to accessories used on complex wheelchairs,” commented Don Clayback, executive director of the National coalition for Assistive and Rehab Technology.

Unfortunately, the ‘reimbursement cuts’ dialogue is far from unique in our industry, but for others, is brand-new. We speak with HME users, caregivers and health care providers daily who are unaware of competitive bidding and how it is impacting or will impact their care. At People for Quality Care, we are working diligently with advocacy partners to educate HME users about upcoming healthcare changes and need your help! Supplement our efforts by educating, preparing and engaging your clients as reimbursement cuts near. We have specific action items below.

ESSENTIAL PROVIDER TO-DO’S BEFORE JANUARY 1:

  • ENGAGE IN LEGISLATIVE ADVOCACY: If you want competitive bidding reform or to eliminate complex rehab accessories from the bidding program, mobilize your patients and staff as soon as possible.  Specifically ask your contacts to ask their Congressional leaders via electronic message or phone to attach S. 2312, H.R. 2339, and S. 2196 to a larger bill before the end of the year.  A swell of action is needed within the next couple days if we want our legislative fixes to be passed and enacted by Dec. 31. Electronic messages to Congress can be submitted at: www.peopleforqualitycare.org/takeaction.
  • EDUCATE: Inform your patients about competitive bidding and its impacts. You can find patient-friendly talking points here.
  • PREPARE: Specifically explain how reimbursement changes will impact your patients’ care. We recognize that mobility users may be charged more or asked to pay for their equipment up front. If you are a mobility provider, make sure to download and distribute this FAQ sheet to your patients. This resource, co-created with U.S. Rehab, concisely explains to your patient why their out-of-pocket expenses have increased.
If your patients want additional information about medical equipment access changes, invite them to visit www.peopleforqualitycare.org or call us at 800-260-7913. We are here to help!

 

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