Medical Billing And Coding Companies

Competitive Bidding Report

The Council for Quality Respiratory Care (CQRC) recently said that the data released by CMS in their latest competitive bidding report does not truly reflect on the effect of Medicare cuts enforced on Durable Medical Equipment, Prosthetics, Orthotics & Supplies (DMEPOS) and the home respiratory treatments. Effective Jan. 1, 2016, CMS started to apply the competitive bidding rates to remote as well as non-competitive bid areas, which were earlier used in urban setting only. Though this led to a 30-50% cut to home-based respiratory therapies, CMS is moving ahead with its plan to apply competitive bid rates in every possible area by July 1, 2016.

According to CQRC, this puts at risk a patient’s access to superior and advanced respiratory treatment procedures, and could lead to higher Medicare spending eventually. Speaking on the matter, CQRC Chairman Dan Starck said, “Home respiratory care is essential to lowering overall Medicare spending, however these cuts limit our ability to offer the quality services our patients need to remain in the home. As of July 1, we face the second half of the cuts to home respiratory care, resulting from the end of the phase-in period, and a new set of cuts of 18 percent or more due to another round of competitive bidding.

CMS earlier suggested that the adjustment fee schedule rates for DEMPOS would be enough to cover the entire costs related to providing healthcare services, which include home-based respiratory therapy as well. But CQRC feels that the projected data does not reveal the full impact the competitive bidding would have on beneficiary access and Medicare costs.

Medical Billing Outsourcing

Effect Of Medicare Cuts

“Home respiratory therapy providers have warned that if implemented on July 1, these cuts will result in an unavoidable reduction in services. It is important that policymakers fully understand the impact of these cuts on the patient community, including the shift of our patients to more expensive settings,” Starck said in a press release. He also added that at least a 15-month study is required to evaluate the actual effect the bidding system and the cuts.

“We applaud CMS for their ongoing commitment to monitoring the impact of payment rate adjustments on beneficiary access, however we ask that they allow more time and examine the full range of data necessary to fully study the impact of cuts on both cost and patient outcomes before further cuts are implemented,” Starck added.