The Centers for Medicare & Medicaid Services (CMS) is changing the way it deals with medical equipment repairs.
In response to complaints from patients across the nation, CMS has admitted that patients are having trouble getting equipment repaired and has released new guidance on supplier documentation for durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) repair claims.
CMS has instructed its Medicare Administrative Durable Medical Equipment Contractors (DME MACs) to only review the necessity of the repair when making a payment determination.
“From patient complaints to members of Congress, it has taken many voices to help CMS understand that the current state of medical equipment repair is unacceptable,” said AAHomecare CEO Tom Ryan. “This new guidance is a step in the right direction towards fixing the convoluted and confusing documentation requirements.”
AAHomecare is reviewing the new guidance for its impact on the industry, however upon first review; providers will now be able to repair equipment, such as power wheelchairs, without the need to find the original medical necessity documentation from the original provider, many of whom are now out of business. If Medicare paid for the base equipment initially, medical necessity for the base equipment has been established. This guidance for repairs is to be applied to all DMEPOS equipment owned by Medicare beneficiaries as of November 4, 2014.
Specifically, contractors shall only review for continued medical necessity of the item and necessity of the repair. Contractors shall not expend resources to determine if the requirements for the initial provision of the DMEPOS item as/when it was originally ordered were met.
“AAHomecare has worked hand in hand with CMS to come to a resolution on this very important issue,” said Kim Brummett, vice president of AAHomecare regulatory affairs. “I am excited to see CMS listening and responding to industry concerns. This development is evidence of the success of collaboration.”
Medicare’s inability to arrange repairs for patients’ power wheelchairs has become widespread as a direct result of a national Medicare bidding program. The way CMS awarded contracts has driven hundreds of companies out of business and proven to be a danger to the very people it is supposed to help.