Review the Proposed Rule and Submit Comments

The Proposed Rule continued...

The “regions” mirror the current regions used for unemployment analysis by the BEA:

CMS adjusts fee schedules for states in different regions of the country based on previous competitive bidding round pricing in these “regions.” The regional prices are limited by a national ceiling (110% of the average of regional prices) and floor (90% of the average of regional prices). For example, Colorado non-bid areas will be reimbursed at the weighted average of not only the CBAs within the state, (Denver and Colorado Springs) but also the other CBAs in the Rocky Mountain region, such as Boise and Salt Lake City. What about these CBAs? What will suppliers be paid for the next three years? The proposal includes:

For items that were included in Round 2021 but have essentially been removed from

Round 2021 of the CBP, we are considering whether to simply extend application of the current fee schedule adjustment rules… until new SPAs are calculated for the items once competitive bidding of the items has been resumed.

Effectively, the current reimbursement amounts in the 130 CBAs would remain the same until a new bidding program came into effect.

Review the Proposed Rule and Submit Comments

CMS published a formal notice in the Federal Register, which included the offering of public comments and a deadline for submission. I urge all stakeholders to review the actual documents and proposed rule if you have accessed this information prior to the deadline of Jan. 3, 2021.

Submitting Comments on the Proposed Rule

Electronically: Go to www.regulations.gov and follow the “Submit a comment” instructions.

By regular mail: Send comments to Centers for Medicare & Medicaid Services Department of Health and Human Services, Attention: CMS1738-P, P.O. Box 8013, Baltimore, MD 212448010.