News Feature | May 14, 2015

Bill Seeks To Expand Medicare's DME Coverage To Include Disposable Devices

By Jof Enriquez,
Follow me on Twitter @jofenriq


A new measure recently filed by Sens. Richard Burr (R-N.C.) and Michael Bennet (D-Colo.) is seeking to expand Medicare’s durable medical equipment (DME) benefit to cover newer, disposable medical devices and equipment.

The proposed Patient Access to Disposable Medical Technology Act of 2015 would require Medicare to reimburse disposable products that are not considered as “durable” as presently defined in the Medicare law. Current rules require long-term durability of products to be eligible for the DME benefit.

According to a press release from Burr’s office, the “statutory definition of DME is decades old and written at a time when typical DME products were items like wheelchairs and crutches. Today, a number of innovative, disposable technologies have become available to patients that can be easier to use and less expensive than their durable counterparts and provide benefits to patients.”

The bill’s authors explain that many patients transitioning from hospital care into home care are facing health gaps. Upon discharge, many older patients lose access to newer products and devices they have used in the hospital setting. Instead, they make do using older technologies just so they can continue receiving Medicare benefits. This disruption in the continuity of care is linked to adverse patient outcomes and readmissions.

“Seniors shouldn’t have to live with bulky, outdated medical technologies when there are better, modern options available to them,” Burr said in a statement. “This relatively simple bill will help seniors get new technologies that will enable them to heal faster and better meet their needs so that they can enjoy a better quality of life.”

“Medical innovation has helped make life easier for a lot of Colorado seniors,” Bennet said in the same statement. “Unfortunately, Medicare hasn’t kept pace to ensure beneficiaries have access to innovative, disposable technologies that are easy to use and often less expensive. This bill makes a simple update to the Medicare program to ensure both disposable and durable technologies are covered.”

The bill proposes a payment rate for newer technologies to be 95 percent of the analogous DME product. If passed, the legislation would not only help spur the development of innovative, cost-effective, and easy-to-use products, but lower Medicare costs as well, the authors said in the press release.

The Advanced Medical Technology Association (AdvaMed) expressed its support of the new bill updating Medicare’s DME policy.

“As medicine advances and innovation occurs in the treatment of injuries, illnesses, disabilities, and chronic conditions, Medicare beneficiaries are losing access to disposable forms of durable devices that traditionally have been covered under the DME benefit,” Stephen J. Ubl, president and CEO, AdvaMed, said in a statement.

“The legislation introduced today will eliminate this obstacle, providing beneficiaries and their physicians the additional choice of a disposable medical technology to meet their individual need,” he added.