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Repeals the option for Medicare to purchase power-driven wheelchairs with a lump sum payment, requiring that payments be made under the traditional 13-month rental period for durable medical equipment. Does not apply to complex, rehabilitative power wheelchairs.
CMS implemented this provision in the CY11 Physician Fee Schedule Final Rule.
On July 14, 2015 CMS announced the extension of the Medicare PMDs demonstration for an additional 3 years, until August 31, 2018.
2016
On June 24, CMS announced the release of the July 2016 DMEPOS fee schedule amounts. The DMEPOS and schedule amounts for certain items that were adjusted based on information from the DMEPOS Competitive Bidding Program.
On June 24, CMS released the calendar year 2017 proposed rule for the end-stage renal disease (ESRD) prospective payment system (PPS), which updates rates for renal dialysis services provided to Medicare beneficiaries on or after Jan. 1, 2017. CMS anticipates that aggregate ESRD PPS payments to dialysis facilities will increase by about $50 million in CY 2017, with $30 million stemming from the payment rate update and $20 million from updates to the outlier threshold amounts. This translates to an estimated +0.5 percent net rate update to ESRD facilities in CY 2017 compared with CY 2016. Comments are due by Aug. 23, 2016.
SEC. 3136. REVISION OF PAYMENT FOR POWER-DRIVEN WHEELCHAIRS. (a) IN GENERAL.—Section 1834(a)(7)(A) of the Social Security Act (42 U.S.C. 1395m(a)(7)(A)) is amended— (1) in clause (i)— (A) in subclause (II), by inserting ‘‘subclause (III) and’’ after ‘‘Subject to’’; and (B) by adding at the end the following new subclause: ‘‘(III) SPECIAL RULE FOR POWER-DRIVEN WHEELCHAIRS.—For purposes of payment for power-driven wheelchairs, subclause (II) shall be applied by substituting ‘15 percent’ and ‘6 percent’ for ‘10 percent’ and ‘7.5 percent’, respectively.’’; and (2) in clause (iii)— (A) in the heading, by inserting ‘‘COMPLEX, REHABILITATIVE’’ before ‘‘POWER-DRIVEN’’; and (B) by inserting ‘‘complex, rehabilitative’’ before ‘‘power-driven’’. (b) TECHNICAL AMENDMENT.—Section 1834(a)(7)(C)(ii)(II) of the Social Security Act (42 U.S.C. 1395m(a)(7)(C)(ii)(II)) is amended by striking ‘‘(A)(ii) or’’. (c) EFFECTIVE DATE.— (1) IN GENERAL.—Subject to paragraph (2), the amendments made by subsection (a) shall take effect on January 1, 2011, and shall apply to power-driven wheelchairs furnished on or after such date. (2) APPLICATION TO COMPETITIVE BIDDING.—The amendments made by subsection (a) shall not apply to payment made for items and services furnished pursuant to contracts entered into under section 1847 of the Social Security Act (42 U.S.C. 1395w–3) prior to January 1, 2011, pursuant to the implementation of subsection (a)(1)(B)(i)(I) of such section 1847.
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