AAHomecare Fights Proposal to Restrict HME in Medicare Advantage

The American Association for Homecare is urging the Centers for Medicare & Medicaid Services  to withdraw proposed changes to HME coverage under Medicare Advantage plans. The changes, included in a proposed rule, would allow Medicare Advantage plans to limit HME coverage to specific products or brands based on whether a plan has negotiated “bulk discounts” with the manufacturer.

In a letter, AAHomecare expressed concern that creation of these DME formularies would limit access to brands or products that may be better suited to a beneficiary’s specific medical needs. All brands are not interchangeable, AAHomecare said.
Examples of HME products that often must be customized include PAP devices, ostomy products, diabetic testing supplies, power wheelchairs and wheelchair seating products, the organization noted.