Wound Care Nets Reimbursement “Wins” With Bipartisan Budget Act

The signing of the Bipartisan Budget Act of 2018 that took place Feb. 9 received much in the way of national media coverage because it ended the United States’ governmental shutdown. However, the act also provided the wound care industry some “wins” that were not well publicized. This article will focus on the major “wins” that pertain to wound care professionals who work in outpatient provider-based departments (PBDs) as well as various other sites of care and payment models.




Hospital-based outpatient wound care PBDs are required to have direct physician supervision when Medicare beneficiaries are receiving therapeutic services. However, these same departments that are housed in critical access hospitals (CAHs) were exempt from the direct supervision requirement until 2014, when the Centers for Medicare & Medicaid Services (CMS) announced that it was going to enforce the direct-supervision requirement for CAHs. At that time, Congress stepped in and prevented CMS from enforcing the direct-supervision requirements for 2014, 2015, and 2016. However, Congress did allow CMS to enforce direct supervision in CAHs effective Jan. 1, 2017. That new requirement surprised many and caught staff members in the CAH space off guard, especially among those who did not have the availability of physicians or other qualified healthcare professionals who could be immediately available when patients were receiving care in the PBDs … read more