Via AAHomcare, WASHINGTON, DC (January 5, 2018)—CMS has revised its initial guidance to state Medicaid directors on compliance with CURES legislation provisions regarding the Federal allowable for Medicaid reimbursement. While CMS’s December 27 letter required that “States electing to submit an aggregate payment comparison, or an alternative approach to compliance as mentioned earlier in this letter, will inform CMS of that choice by December 31, 2017...,” a new January 4 letter gives more open-ended guidance:
"States electing to submit an aggregate payment comparison, or an alternative approach to compliance as mentioned earlier in this letter, will work with CMS to determine the best approach to calculate the FFP limit for their state using expenditures for the period of January 1, 2018 through December 31, 2018."
When this initial guidance was released on December 27, AAHomecare quickly registered concerns with CMS on the short time-frame given state Medicaid agencies, and the Association also worked with HME stakeholders to make sure that officials at these agencies were engaged in asking CMS for relief on the untenable January 31 deadline.
“We appreciate the quick response by our state and regional association partners in making their state Medicaid agency contacts aware of this issue,” said Tom Ryan, AAHomecare’s president and CEO. “CMS also deserves credit for taking these concerns into consideration and issuing updated guidance. This change will allow states to make better informed decisions on how to allocate their resources and maintain access for Medicare beneficiaries who depend on home medical equipment and related services.”
AAHomecare will work with its members and with state and regional association partners to help state Medicaid agencies implement the CURES-mandated reimbursement policies, including making sure that reimbursement adjustments are only applied to the 255 HCPCS codes targeted by the legislation. The Association will also continue to lead the way on efforts to roll back recent unsustainable Medicare reimbursement cuts that provide the basis for a variety of payers, including Medicaid MCOs.
“Now that reimbursement cuts based on competitive bidding-derived pricing are set to start impacting Medicaid beneficiaries, I believe many HME suppliers are going to struggle to serve this highly vulnerable patient population,” added Ryan. "The home medical community needs relief soon—whether in the form of Congressional action or gaining the release of the HME-related Interim Final Rule now under consideration at OMB—or individuals and caregivers who rely on Medicaid are going to pay a steep price.”
You can read CMS's updated guidance here.
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