The Centers for Medicare and Medicaid Services will not finalize a 2020 proposal to let Medicare beneficiaries receive more drugs through home infusion by covering external infusion pumps, the agency announced in a final rule published Tuesday.
Durable medical equipment providers will continue to get higher reimbursement for providing items and services in rural areas, the rule also spells out.
Under the now-final policy, medical equipment suppliers in rural areas, Alaska, Hawaii and the territories will continue to be paid rates that are half of the regular fee schedule amount combined with half of an adjusted rate for rural providers. Stakeholder input showed higher costs, greater travel expenses, logistical difficulties and other challenges associated with providing equipment and services in rural areas, the regulation says.
CMS also finalized interim pricing for durable medical equipment during the public health emergency, as mandated through a COVID-19 relief law enacted in March 2020.
The statute require certain products provided in rural and non-contiguous states and territories that also are not competitive bidding areas be reimbursed at the 50/50 blended rate throughout the public health emergency. Items furnished in all other non-competitive bidding areas will be paid a blend of 75% of the adjusted fee schedule amount and 25% of the unadjusted fee schedule amount.
In addition, the agency established a public input process about what categories new durable equipment, prosthetics, orthotics and more should be placed into, a necessary step to determine whether Medicare covers products. Stakeholders also will be able to comment on payment for those items.
But CMS won't move forward with an idea to cover external infusion pumps deemed medically necessary. Commenters on this element of the proposed rule said the policy was unclear and raised concerns about costs and safety, according to a CMS news release.
In addition, the final rule classifies continuous glucose monitors as durable medical equipment under Medicare Part B.