On Monday April 30, the Office of Management and Budget published that the proposed rule CY 2019 Changes to the End-Stage Renal Disease (ESRD) Prospective Payment System, Quality Incentive Program, Durable Medical Equipment, Prosthetics, Orthotics, and Supplies was under review.
The most recent iteration of this rule, which is statutorily mandated each year to address ESRD rates, did not include any DME-related provisions when it was finally released to the public in late June 2017. The 2016 edition of the rule included several items related to future DME competitive bidding rounds, including changing the bid ceiling to the unadjusted 2015 Fee Schedule, a provision for lead item bidding for certain product categories, and requirements for bidders to obtain surety bonds for each CBA associated with their bid.
While there is no guarantee that DME-related provisions will be included in the 2019 ESRD rule, this next round could be a vehicle for structural reforms for the bidding program that AAHomecare has advocated for with this Administration, as well as for setting a date for the next bidding round to take place.
Given the consistent release schedule for the ESRD rule in previous years dating back to 2014, we should expect to see the proposed rule in late June, with a final rule published in late October. AAHomecare is working to find out more about the proposed rule and will report any additional developments.