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CQCRC Praises Competitive Bidding Reforms, Pledges to Work with CMS and Congress to Refine DMEPOS Policies


Final DMEPOS rule will make market more competitive and protect oxygen access to Medicare beneficiaries, but serious concerns remain.

Washington, DC, November 06, 2018 --(PR.com)-- The Council for Quality Respiratory Care (CQRC) - a coalition of the nation's leading home oxygen therapy provider and manufacturing companies - commended the Centers for Medicare & Medicaid Services (CMS) for finalizing reforms to the competitive bidding program (CBP) for durable medical equipment, prosthetics, orthotics, and Supplies (DMEPOS) - including home oxygen supplies and equipment - in a Final DMEPOS Rule for 2019 issued on November 1. These reforms were first proposed in July.

By allowing the market to set prices, instead of mandating half of suppliers accept reimbursement rates far below their maximum bids, the Final Rule will help protect access to home respiratory therapy supplies and equipment for the millions of Americans who require home respiratory care to remain independent at home, which has eroded since the inception of the competitive bidding program. The Final Rule now requires payment amounts based on the maximum bid of lead items in each product category.

“We commend CMS leadership, including Administrator Seema Verma, and CMS staff for meeting with stakeholders like CQRC and seriously considering our constructive feedback, as well as patient voices, when crafting this Final Rule,” said Dan Starck, Chairman of the CQRC. “It will be important for suppliers to understand how these reforms change rate setting and incorporate these changes into their bidding behavior. Today is a step forward, not only for providers who can now compete more effectively in the market, but ultimately for Medicare patients with serious respiratory conditions, including chronic obstructive pulmonary disorder (COPD), the third leading cause of death in the United States.”

While the Final Rule marks a major milestone for patients and providers throughout the home respiratory care sector, CQRC remains concerned that applying the budget neutrality factor to home oxygen therapy will continue to create access problems for patients. Now that the fee schedule for home respiratory supplies and equipment is based on competitive bidding program (CBP) rates, it makes little sense - fiscal or health-wise - for the budget neutral requirement to remain in place.

CQRC applauds CMS for recognizing the budget neutrality problem as it pertains to liquid oxygen, for which it has indicated it believes the budget neutral requirement to be statutory, and urges Congress to repeal the budget neutrality requirement to protect access to liquid oxygen and other home oxygen equipment.

CQRC also remains concerned the application of the competitive bidding rates determined under the previous methodology to non-competitively bid areas (CBAs) will harm patients. While CMS found there is a difference in the volume of services in these areas, it has not yet acknowledged those differences increase the costs of providing home oxygen supplies and equipment in those markets.

In addition, CQRC is troubled CMS has proposed to add home ventilators, which are used by the most vulnerable Medicare beneficiaries, to the next round of the competitive bidding program without first testing the new methodology. CQRC expressed its hope to continue working with CMS to address these issues so patient access to home respiratory care is not disrupted.

“As we continue working to expand access to home respiratory therapy to vulnerable Americans who need it to maintain quality of life while they manage their respiratory illness, we look forward to working with stakeholders at CMS and in the Congress to craft future policy revisions that further help Medicare beneficiaries obtain life-saving oxygen,” added Starck.

About the Council for Quality Respiratory Care
The CQRC is a coalition of the nation's seven leading home oxygen therapy provider and manufacturing companies. To learn more, visit cqrc.org and follow CQRC on Twitter at @TheCQRC.
Contact Information
The Council for Quality Respiratory Care
Ellen Almond
703-548-0019
Contact
http://cqrc.org/

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