The following supplements information in the June 28, 2010 Hot Button summarizing the various DME/oxygen provisions contained in the Centers for Medicare & Medicaid Services” (CMS) 2011 Proposed Medicare Physician Payment Rule, which is now scheduled to be published in the Federal Register July 16, 2010.
CMS’ proposed rule implements the provision contained in the Patient Protection and Affordable Care Act (PPACA) that will eliminate the first-month purchase option for standard power-driven wheelchairs that are not provided as part of Round 1 of the competitive bid program. The proposed rule is consistent with the PPACA statutory language which provides that the elimination of the first month purchase option will not apply to contracts that are entered into prior to January 1, 2011 under the DME competitive bid program.
Under this provision, CMS will retain the first-month purchase option for Group 2 chairs with power options and for Group 3 chairs. This provision applies to standard power wheelchairs provided after January 1, 2011 (though it will not apply to these items that are provided under Round 1 of the competitive bidding program, as long as the contracts are entered into prior to January 1, 2011).
Also consistent with PPACA, payment for standard power wheelchairs provided as rental items will be paid 15 percent of the purchase price for the first three months under the 13 month rental period and 6 percent for the remaining months (months 4-13). At month 13, the rental will convert to a purchase, similar to other capped rental items.
