Plus: HHAs will enjoy a bigger-than-expected payment boost.
Medicare won't cover infrared therapy devices for treatment of diabetic and non-diabetic sensory neuropathy, wounds and ulcers, the Centers for Medicare & Medicaid Services (CMS) announced. This includes the treatment of related pain.
Non-covered therapies include monochromatic infrared energy (MIRE), according to decision memo CAG-00291N. For more info, go to
www.cms.hhs.gov/coverage and click "What's New." Medicare Pays HHAs More Next Year Home health agencies (HHAs) will receive a 3.3-percent increase to Medicare payment rates starting Jan. 1, 2007, CMS announced Nov. 1.
That's up slightly from the 3.1-percent increase CMS suggested in its Aug. 3 proposed rule on next year's prospective payment system update.
Agencies that don't submit OASIS data will see only a 1.3-percent increase, CMS notes in a release. Rural agencies will receive an average 3.6-percent higher rate while urban agencies will see a 3.1-percent increase. Don't Shutter Your Condo Labs Just Yet Good news: For now, CMS won't go ahead with proposed changes to the self-referral regulations that would have made it almost impossible for you to operate a "pod lab" or "condo lab" at an off-site lab company. CMS said it needs more time to study the comments it received on this proposal and come up with a regulation later. CMS May Be Wrong About Increasing Claims For PMDs CMS is mistaken in its assertion that claims for power mobility devices (PMDs) are on the rise--and government data can prove the agency is in the wrong.
That's the latest volley in a battle between the power mobility industry and CMS over pending cuts in Medicare rates for PMDs, which include power wheelchairs and scooters.
A fee schedule released last month and set to go into effect Nov. 15 slashes PMD rates by as much as 41 percent, reports Michael Frisby of Restore Access to Mobility Partnership (RAMP), a coalition representing power wheelchair providers and manufacturers.
Making a case for the necessity of the cuts, CMS said that utilization has increased 2,700 percent in the last nine years. But an analysis of data from the federal government's Statistical Analysis Durable Medical Equipment Regional Carrier shows that utilization of Medicare's mobility benefit has declined significantly since 2003.
There was a 29 percent drop from 2003 to 2004, reports RAMP. In 2005, utilization increased at a rate of only 8 percent over 2004.
"It is certainly misleading for CMS to contend that some big, recent surge in utilization calls for these draconian cuts," says Invacare CEO Mal Mixon, in a statement released by RAMP. CERT Program Certified With Clean Bill Of Health CMS has appropriate controls in place to make sure its Comprehensive Error Rate Testing (CERT) program is coming up with accurate data, the HHS Office of [...]
