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News & Press: Government Affairs News

AAOE Submits Comments to CMS on Late Year DME Proposal

Sunday, November 18, 2018   (0 Comments)
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Indianapolis, IN - The American Alliance of Orthopaedic Executives has submitted comments to the Centers for Medicare and Medicaid Services (CMS) on a late year proposal that would drastically alter the way in which Medicare pays for off-the-shelf back and knee braces. 

The proposal, released on November 5, 2018, would subject HCPCS codes L0450, L0455, L0457, L0467, L0469, L0621, L0623, L0625, L0628, L0641, L0642, L0643, L0648, L0649, L0650, L0651, L1812, L1830, L1833, L1836, L1848, L1850, L1851, and L1852 to the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. Under the Competitive Bidding Program, CMS collects bids from DMEPOS suppliers seeking to have their devices covered for Medicare reimbursement. CMS then awards contracts to the lowest bids and requires that those supplier's products be purchased or rented from Medicare beneficiaries in order to be a covered benefit.

AAOE's first set of comments focused on extending the comment deadline from December 3, 2018 to February 5, 2019. Under the current timeline, CMS has only given stakeholders 18 business days to provide comment on a potentially care-altering proposal. In her comments to CMS, AAOE 2018-2019 President Karen Sollar, CMPE wrote that "feedback from our members, their physicians, patients, and durable medical equipment suppliers is critical to ensuring that patient care is not compromised and we do not believe that CMS’ comment timeline allows for a thorough analysis of, and comment on, the proposal."

AAOE also commented on the manner in which public comment on the proposal was solicited: "CMS released this proposal outside of its normal rulemaking processes, posting the proposal on a “hidden” section of the CMS website ensuring that few, if any, stakeholders would see the proposal and provide public comment. Not only is this a dangerous precedent to set, it deprives CMS of stakeholder input that can help guide the agency as it considers finalization of this policy."

"They've certainly gone about the process of public comment in an odd way," Bradley Coffey, AAOE Manager of Government Affairs stated. "Typically we would see a proposal of this magnitude in the annual rulemaking for the DMEPOS program rather than posted on the CMS website."

As of this writing, you have until December 3, 2018 to submit your comments. Those must be emailed to DMEPOS@cms.hhs.gov. In order for your comment to be considered, you must type “Competitive Bidding Product Categories” as the subject line for your email. Only comments submitted by 11:59:59 PM Prevailing Eastern Time on December 3, 2018, with the subject line above will be considered.


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