The Centers for Medicare and Medicaid Services (CMS) released its annual final rule regarding changes to the 2020 Medicare payment rules for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) on October 31. It will be published in the Federal Register on November 8. CMS issued the proposed rule in July.
The American Orthotic and Prosthetic Association (AOPA) released a statement that it had submitted comments on the proposed rule with concerns about proposed changes to the gap-filling methodology that Medicare is required to use to establish Medicare fee schedules for new Healthcare Common Procedure Coding System (HCPCS) codes; the proposed combination and expansion of the Master List of HCPCS codes subject to prior authorization; face-to-face visit requirements; written orders prior to delivery; and the authority of CMS to reduce Medicare fee schedules for products that have had price reductions through market competition within five years of creation of a new HCPCS code.
AOPA said that CMS acknowledged the comments in response to the proposed rule, but the only section that it elected not to finalize was a provision about technology assessments, which CMS said it will consider in the future.
To read the final rule, visit https://s3.amazonaws.com/public-inspection.federalregister.gov/2019-24063.pdf.
To read about the proposed rule, visit “DMEPOS Proposed Rule Expands O&P Prior Authorization, Underscores Need For Legislation To Separate O&P From DME.”