Based on a preliminary analysis, the American Orthotic & Prosthetic Association (AOPA) said that the single payment amounts for off-the-shelf knee and back braces under Round 2021 of competitive bidding will be about 30 to 35 percent below Medicare’s current fee schedule.
In October, the Centers for Medicare & Medicaid Services (CMS) announced the single payment amounts for braces in 127 competitive bidding areas (CBAs). CMS expects to save $600 million for the Medicare program and beneficiaries over the three-year contract period. It has now begun the contracting process and expects to name contract suppliers this fall. At that time, CMS said it heard from a range of stakeholders requesting that the agency delay or cancel the durable medical equipment, prosthetics, orthotics, and supplies Round 2021 competitive bidding program due to the COVID-19 public health emergency, and that it considered that feedback while moving forward.
“The COVID environment business conditions are not anything like what they were when bids were submitted in good faith,” Joe McTernan, AOPA’s director of coding and reimbursement services, education and programming, told HME News. “We are in the middle of a pandemic so there’s already concerns about access. To now significantly limit access to only a select group of providers is a concern.”