—Via AAHomecare, WASHINGTON, D.C. (September 14, 2017)—As previously noted, CMS has issued blanket waivers for new physician’s orders, medical necessity documentation and face-to-face exams for replacement of equipment, accessories and supplies that were lost or damaged by recent hurricane activity affecting Texas, Florida, Georgia, South Carolina, Puerto Rico and the U.S Virgin Islands. In addition, the Agency has told AAHomecare that the rental cycle will start over for capped rental and oxygen equipment that are replaced due to these storms.
AAHomecare has provided CMS with input from our members in these areas on the challenges they face, and have also shared suggestions to help suppliers serve Medicare beneficiaries more efficiently in these situations. We have had further engagement with the Agency over the last week to advocate for allowing non-contract suppliers in CBAs to serve patients in these areas and to allow some mechanism to reimburse suppliers for oxygen tanks that are being provided due to power outages.
Feedback from Storm-Impacted Providers Sought
AAHomecare realizes and appreciates that many providers in these areas may be facing significant challenges in restoring operations and serving patients under these conditions. We want to make sure the HME community gets the recognition it deserves for these important and literally life-saving efforts.
Please share any stories/information you have about your challenges and successes serving your patients under these extraordinary circumstances. In light of our ongoing work with CMS on disaster-related policies, we are particularly interested in feedback on these issues:
- Are any non-CB-contract suppliers providing or being asked to provide services in competitive bidding areas?
- Are you providing oxygen tanks in the disaster areas?
RACs to Pause ADR Requests in Affected Areas; Audit Contractors Are Aware of Blanket Waiver Guidance
CMS has provided information on the audit contractor procedures during this current emergency. All of the medical review contractors (RACs, MACs and SMRC) follow the PIM Section 3.8 regarding disaster relief, which means these contractors will not be auditing replacement claims for items provided in the disaster areas.
In addition, the RAC has been instructed to not send additional documentation requests (ADRs) to any suppliers in Texas, Louisiana, Florida, the U.S. Virgin Islands, or Puerto Rico for a period of 30 days. And, for suppliers in FEMA-designated zip codes, which are eligible for direct federal assistance, the RAC will not send ADRs, nor deny any claims, for an additional 30 days (a total of 60 days).
In addition, all of the contractors will follow the blanket waiver guidance for replacement DMEPOS. Suppliers are to be reminded to include the necessary documentation in the medical record regarding the destruction of applicable records and to use the appropriate codes on all claims.
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