Congress has finalized the language for the Omnibus spending bill to allow the government to continue operations through 2016. The bill is scheduled for a vote today (December 16th). DME stakeholders were hopeful this legislative vehicle would include provisions from the newly introduced House bill (the PACT Act of 2015) and the comparable Senate bill (the DME Access and Stabilization Act of 2015) which seek to soften the blow of national rate reductions to the Medicare fee schedule. Congress did not include any relief for DME providers, but did incorporate the pay-for from the DME bills.
If the Omnibus bill passes state Medicaid agencies will be required to match Medicare fee schedule reimbursement rates (including single payment amounts in applicable areas) beginning January 1, 2019. Where a Medicare rate does not exist (for products such as diapers) Medicaid will continue to establish rates independently. In addition to the fee schedule cuts, this burden will increase the complexity of Medicaid claims processing which is already a struggle for many suppliers.
With the elimination of the pay-for that is attached the DME bills, it is unlikely that these bills can pass independently. We will continue to keep you posted as additional information develops.