South Carolina Wins Rate Protections for Key Medicaid Categories

Washington, D.C. (June 27, 2019)—Years of relationship-building between AAHomecare, the South Carolina Medical Equipment Services Association (SCMESA) and South Carolina Medicaid (SC Medicaid) is paying off for durable medical equipment (DME) providers in the state, AAHomecare reports.

SC Medicaid began discussions with SCMESA and AAHomecare several months ago on changing their rates to mirror Medicare’s non-rural rates, an approach favored by a consulting firm hired by the state. It caught SC Medicaid’s attention when the SCMESA Medicaid Committee pointed out the access issues that simply adopting Medicare rates would have on the state’s most vulnerable population, especially in rural areas.

SC Medicaid officials recently reported they will exempt key product categories from the rate change in order to maintain adequate access to care. The protected categories include: oxygen, PAP, PAP supplies, ventilators, nebulizers, enteral, hospital beds, wheelchairs, and some specific wheelchair accessories.

Of the 989 DME HCPC codes on the South Carolina Medicaid fee schedule, 568 will receive increases, 188 will be decreased, and 233 codes will stay the same.

“This win was truly a team effort,” remarked Laura Williard, vice president of payer relations for AAHomecare. “We’re proud to have partnered with SCMESA to help protect patient access across several DME product categories.”