April 4, 2007
On April 2, 2007, CMS released two significant news items which may be of interest to RAP members. First, CMS issued a final regulation implementing a competitive bidding program for certain durable medical equipment, prosthetics, orthotics, and supplies (commonly referred to as DMEPOS). Second, CMS issued guidelines for a contingency plan for covered entities that will not meet the May 23, 2007, deadline for compliance with the National Provider Identifier (NPI) regulations.
DMEPOS Final Regulation
The final rule was placed on display at the Office of Federal Register on April 2, and is expected to appear in the Federal Register within a couple of weeks. Under the final rule, a competitive bidding program will be phased in beginning in April 2007 and conclude by 2010. Initially, the program will operate in "competitive bidding areas" (CBAs) that include ten of the largest metropolitan statistical areas other than New York, Los Angeles, and Chicago. The program will apply initially to 10 categories of DMEPOS. Beginning in April 2007, CMS will solicit bids from DMEPOS suppliers to establish single payment amounts for each CBA, with such payment amounts going into effect in April 2008.
To see the final rule on display at the Office of Federal Register, go to www.cms.hhs.gov/CompetitiveAcqforDMEPOS/02_regsnotices.asp. When published in the Federal Register, the final rule can be found at www.access.gpo.gov/su_docs/fedreg/frcont07.html.
For more information about the final rule, such as the CMS press release and background information, go to www.cms.hhs.gov/competitiveacqfordmepos/01_overview.asp.
NPI Contingency Plan
On April 2, 2007, CMS announced a contingency plan for covered entities (i.e., other than small health plans) who will not meet the May 23, 2007, deadline for obtaining a National Provider Identifier (NPI) in compliance with the NPI regulations under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The final rule published in 2004 mandated that all healthcare providers have NPIs by May 23, 2007, except for small health plans which have until May 23, 2008. To qualify for the contingency plan protections, a provider must have been making a good faith effort to comply with the NPI provisions.
For more information about CMS' contingency plan and enforcement of the NPI regulations, go to www.cms.hhs.gov/NationalProvIdentStand/Downloads/NPI_Contingency.pdf.
More information and education on the NPI can be found at the CMS NPI page at www.cms.hhs.gov/NationalProvIdentStand on the CMS website.
We would like to thank Jim Flynn (Bricker & Eckler LLP, Columbus, Ohio) for providing this email alert.