Medicaid Policy Wins in Virginia, New York Take Effect

The American Association for Homecare (AAHomecare) released updates on state-related Medicaid policies and reimbursement rate increases. 

Virginia Gains in CRT, NIV and Enteral Policies

Virginia Medicaid durable medical equipment (DME) policy was updated on Jan. 1 to include several revisions sought by industry advocates. Key changes include:

• Adding coverage of complex rehab technology (CRT) for Medicaid recipients living in a nursing facility. This is the result of a multi-year effort in collaboration with United Spinal Association of Virginia, who spearheaded legislation to support this change.
• Updating noninvasive ventilation (NIV) policy to allow for continuous rental instead of only capping.
• Enhancing the enteral policy to allow for certain formula substitutions in the event of formula shortages. 

AAHomecare said these policy gains are the result of collaborative efforts to build and maintain strong relationships with Virginia Medicaid leaders by AAHomecare’s payer relations team and its partners at the Atlantic Coast Medical Equipment Services Association (ACMESA), and set the stage for continued engagement going forward. See the updated VA DME policy guide for more details.

Enteral Rates Get Significant Boost in New York

In New York, Medicaid enteral reimbursement rates saw rate increases between 10%-36% for seven codes, effective Jan. 1. the Northeast Medical Equipment Providers Association’s (NEMEP) payer relations committee, led by AAHomecare’s David Chandler, made a case to Medicaid officials to secure the substantial rate increases. See the New York enteral rate increases here.