inherent reasonableness

On June 26, 2012, CMS published a notice announcing that it is considering using its “inherent reasonableness” (IR) authority to establish special Medicare payment limits for diabetic testing supplies furnished on a non-mail order basis.  Under the statutory IR authority, CMS can adjust certain Medicare Part B payment amounts that are “grossly excessive” (generally cases

CMS has announced that it is considering using its “inherent reasonableness” (IR) authority to establish special Medicare payment limits for diabetic testing supplies furnished on a non-mail order basis.  Under the statutory IR authority, which was codified in a 2005 final rule, CMS can adjust certain Medicare Part B payment amounts that are “grossly excessive”