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CMS Releases Updates for HME/DME Providers

Last week, the Centers for Medicare and Medicaid Services (CMS) released updates surrounding two home medical equipment (HME) products. The first issued limits surrounding manual wheelchairs and the decision stated that providers are not allowed to use K0108 for titanium or heavy duty upgrades for manual wheelchairs.

According to Durable Medical Equipment (DME) Medicare Administrative Contractor (MAC) codes for manual wheelchairs—K0001 through K0009—have always accounted for the cost of upgraded materials. According to HME News, providers will now have to bill “non-assigned” for manual wheelchairs with titanium and heavy duty upgrades, leaving beneficiaries to pay up front for the total cost of the chair.

HME News also reported on an Office of the Inspector General (OIG) report on market shares for diabetes test strips. According to this report, Medicare’s national mail-order program provided 18 types of diabetes test strips to beneficiaries from July through September 2016. Among these products, the top strip type accounted for 43% of the mail-order market, and the top 10 strip types accounted for 98% of the market.  This report is the second of three OIG reports to determine the market shares of diabetes test strips.

This report is the second of three OIG reports to determine the market shares of diabetes test strips. The OIG conducted the study to help CMS understand which brands of test strips were provided to beneficiaries and to ensure that Medicare beneficiaries had access to their preferred brand of test strip.

CHAP will continue to monitor both of these stories and provide updates as they are made available. 

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