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.
AAHomecare
—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.
WASHINGTON, D.C. (June 13, 2017)—Drive DeVilbiss Healthcare is taking on an expanded leadership role in the home medical equipment (HME) sector by becoming the only HME manufacturer supporting the American Association for Homecare (AAHomecare) as a Platinum-level partner, the highest sponsorship category for the Association.
A letter from AAHomecare defines expectations.
—Via AAHomecare, WASHINGTON, D.C. (June 7, 2017)—With the publishing of the fee schedule by CMS, the HME industry is still awaiting the Department of Defense Health plans and timeline for implementing the Cures Act.
Meet the new board members.
WASHINGTON, D.C. (May 31, 2017)—At the Association’s annual membership meeting at this year’s Washington Legislative Conference, AAHomecare elected new leadership, installing Steve Ackerman (CEO, Spectrum Medical, Inc.—Silver Spring, Md.) as chairman of the Board. Other officers elected include:
People for Quality Care produced a short film featuring clinician testimonials on the program.
WATERLOO, Iowa (May 22, 2017)—If a picture is worth a thousand words, imagine the power of a video. For years, clinicians and case managers have struggled to coordinate care for their Medicare patients who require home medical equipment, services, and supplies under the Competitive Bidding Program (CBP). Meanwhile, CMS reports that there are no issues with CBP and that access has been unaffected.
New legislation builds upon previous prior authorization legislation.
Via AAHomecare—WASHINGTON, D.C. (May 17, 2017)—We have just received confirmation that Congresswoman Marsha Blackburn (R-Tenn.) has formally introduced legislation that would require prior authorization for certain home medical equipment items in higher price ranges. The formal title for HR 2445 will be the DMEPOS Access and Transparency Act of 2017, and may also be referred to as the DATA Act of 2017.
The press for long-term relief continues.
—Via AAHomecare, WASHINGTON, D.C. (May 10, 2017)—AAHomecare continues to press the case for longer-term relief for rural and non-bid area providers, as well as for significant structural improvements to the Competitive Bidding Program with Federal regulators.
The AAHomecare award recognized members who have advanced the community's legislative goals.
WASHINGTON, D.C. (May 4, 2017)—AAHomecare is pleased to announce George Kucka will be the recipient of this year’s AAHomecare/Mal Mixon Legislative Advocate Award at the upcoming Legislative Conference May 24–25, 2017 in Washington, D.C.
The adjustments reflect the July 1–December 1, 2016 period.
—Via AAHomecare WASHINGTON, D.C. (May 2, 2017)—The Centers for Medicare & Medicaid Services has updated the fee schedule for rural and non-bid areas to adjust reimbursements to rural providers for products and services furnished between the July 1–December 31 period.
Much needed relief follows years of AAHomecare regulatory council engagement on this issue.
—Via AAHomecare WASHINGTON, D.C. (April 27, 2017)—The Centers for Medicare & Medicaid Services (CMS) announced significant changes to improve the processing and adjudication of recurring/serial claims for capped rental items and certain inexpensive and routinely-purchased items.