CMS updates guidance for providers, and RACs halt audits in storm affected areas.
—Via AAHomecare, WASHINGTON, D.C.
AAHomecare
The bill would protect manual accessories from bidding-derived pricing and has strong bipartisan support.
WASHINGTON, D.C. (September 12, 2017)—Representatives Lee Zeldin (R-N.Y.) and John Larson (D-Conn) introduced legislation on Monday to exempt accessories for manual CRT wheelchairs from bidding-derived pricing with a strong, bipartisan roster of 42 original co-sponsors (23 Democrats, 19 Republicans). HR 3730 would complement earlier CMS action exempting accessories for group 3 power wheelchairs from bidding-derived pricing.
AAHomecare works with CMS on disaster related policy.
—Via AAHomecare, WASHINGTON, D.C. (August 7, 2017)—CMS and AAHomcare are both dedicated to instituting policies that protect beneficiary and supplier communities that have been affected by Hurricane Harvey. Last week, AAHomecare and several members of the Regulatory Council met with CMS regarding emergency and disaster related policies and procedures.
Additional responses from case managers and beneficiaries still sought
WASHINGTON, D.C. (September 7, 2017)—Last Friday, AAHomecare chairman Steve Ackerman joined Tom Ryan, Jay Witter and Kim Brummett to present updated findings from our Patient Access Survey to CMS officials. Staff from our survey partner Dobson DaVanzo and counsel Foley & Hoag were also in attendance.
Providers step up to provide extra care in the midst of Harvey.
Via AAHomecare, WASHINGTON, D.C. (August 30, 2017)—As the nation rallies around those impacted by Hurricane Harvey’s destruction, we wanted to share some encouraging stories about our members who are rising to meet the needs of their community and beyond. In the midst of tragedy, their response speaks volumes about the services and front-line patient care that our Industry offers, in good weather and bad.
Second quarter deadline is now September 11, 2017.
—Via AAHomecare, WASHINGTON, D.C. (August 30, 2017)—On account of requests from several providers to extend the deadline to enter 2nd Quarter 2017 HME Audit Key data, the survey will remain open until Monday, Sept. 11.
Targets were exceeded, AAHomecare seeks additional participation in all categories.
—Via AAHomecare, WASHINGTON, D.C. (August 24, 2017)—While response totals for all three categories in the survey on patient access to HME have significantly surpassed our original targets, the survey remains open for additional participation from HME patients, case managers/discharge planners, as well as providers.
WASHINGTON, D.C. (August 23, 2017)—Nominate a colleague to be honored as the 2017 Van Miller Homecare Champion. The award recognizes an AAHomecare member who has made an exceptional contribution to the homecare sector throughout their career in one or more of the following ways:
—Via AAHomecare—WASHINGTON, D.C. (August 16, 2017)—Last year, CMS finalized the rule to move forward with expanding the prior authorization (PA) program. Although the program has great support from the industry, AAHomecare expressed concern with the lack of physician involvement in the correspondence of the PA decision. Unlike the PMD Demonstration, under the PA expansion, DME MACs cannot automatically communicate with referring physicians on the PA decision.
WASHINGTON, D.C. (August 16, 2017)—Last month, CMS published the annual Medicare Fee-For-Service Improper Payments Report. CMS reports that for dates of service between July 2014–June 2015, the error rate for DMEPOS was 46 percent, which is an increase of 7 percent from the previous year. For the report, 10,999 DMEPOS claims were reviewed. However, CMS states that the majority of this rate is attributed to insufficient documentation and not due to medical necessity.
—Via AAHomecare—WASHINGTON, D.C. (August 15, 2017)—On account of requests from several providers to extend the deadline to enter 2nd Quarter 2017 HME Audit Key data, the survey will remain open until Friday, August 25.
Meeting and follow-up letter highlighted patient access in non-competitive bid areas.
WASHINGTON, D.C. (August 2, 2017)—AAHomecare’s Kim Brummett and Mina Uehara recently participated in a Government Accounting Office (GAO) interview regarding patient access in non-competitive bid areas and followed up with a letter to the Agency summarizing key points from the session. In discussing the effects on patient access since the 2016 cuts, AAHomecare notes:
Plans are underway to survey the industry on beneficiary access to HME.
—Via AAHomecare, WASHINGHTON,D.C. (July 27, 2017)—AAHomecare is beginning work on a major initiative to assess and report on patient access to HME in areas served by the competitive bidding program as well as in rural and non-bid areas.
WASHINGTON, D.C. (July 27, 2017)—On Tuesday, the House of Representatives passed the Medicare Part B Improvement Act of 2017 (HR 3178). The bill accelerates the implementation of Medicare payment for home infusion services to January 2019, two years earlier than the start date established in last year’s CURES bill. AAHomecare was one of 168 organizations and companies who asked Congressional leadership to move the implementation date forward earlier this year.
Goals for the session included improving the audit and review process.
FARGO, N.D. (July 20, 2017)—Last week, AAHomecare hosted an educational session for DME MAC and PDAC personnel in Fargo, North Dakota, on manual, power and CRT wheelchairs and accessories. Kim Brummett, AAHomecare’s vice president of regulatory affairs, and representatives from member companies who manufacture mobility products were on hand to demonstrate equipment and accessories to approximately 35 individuals involved in audits, coding and claims analysis.
HME organizations go above and beyond in caring for communities.
—Via AAHomecare, WASHINGTON, D.C. (July 20, 2017)—Storms are brewing, and not just the metaphorical kind caused by crushing reimbursement and regulations. As we move into the late summer months, suppliers are readying their companies for hurricanes, tornadoes, floods, heat waves and other disasters that wreak havoc on communities, leaving their customers in need of vital equipment and services.
Operating environment for providers who depend on Medicare remains exceptionally challenging
Rates apply for July 1 through December 31, 2016
WASHINGTON, D.C. (July 7, 2017)—TRICARE is issuing its first official acknowledgements that they will reprocess claims from July 1 through December 31, 2016 to reflect adjustments to the fee schedule mandated by last December’s CURES bill.
-Via AAHomcare, WASHINGTON, D.C. (July 6, 2017)—AAHomecare members are taking advantage of the Retail Work Group to learn new and innovative ways to infuse cash sales into their mix and diversify beyond an insurance-based model.
HME competitive bid data was not included in the update.
WASHINGTON, D.C. (June 29, 2017)—CMS released proposed 2018 changes to End-Stage Renal Disease (ESRD) Prospective Payment System and related kidney/renal disease regulations.
The June 30 deadline for the Cures Act exemption for Group 3 power products is continued indefinitely.
WASHINGTON, D.C. (June 26, 2017)—The Centers for Medicare & Medicaid Services (CMS) today announced that accessories for Group 3 power Complex Rehab Technology (CRT) mobility products will continue to remain exempt from the application of competitive bidding derived pricing for Medicare beneficiaries.
Who spearheaded the effort?
—Via AAHomecare, WASHINGTON, D.C. (June 14, 2017)—AAHomecare received word Monday that the Congressional sign-on letter on HME priority issues “closed” with commitments from 153 members of the House of Representatives. Per the usual procedure with these sign-on letters, Hill staffers are now taking the letter to each of these offices to get an actual signature on the letter.