Earlier this week, CMS released a wide-ranging set of policy modifications to DME policy, ranging from HCPCS code procedures to benefit category determination rules to some specific policymaking, such as for Continuous Glucose Monitors (CGMs).
- See the CMS fact sheet here.
- See the CMS Press Release here.
- "Today, under the leadership of President Trump [etc]."
- See the Proposed Rule Homepage here.
- See the "inspection copy" or typed rule here [211 pages]. [Fed Reg Publication Nov 4]
- The official Fed Reg publication will be November 4 at the homepage cited.
In last year's rulemaking, CMS proposed making a public advisory panel that would advise it on gapfill pricing for DME based on costs. I was alarmed this could occur and could be later applied to genomics also. For example, the panel might have little insight into costs and investments and return on risk capital; they were instructed to look at the end-product and estimate its costs. Here. CMS deferred action on the "pricing panel."