CMS
Effective date of August 1 give providers time to adapt.
WASHINGTON, D.C. (May 14, 2018)—Effective August 1, 2018, the Centers for Medicare & Medicaid Services (CMS) will require suppliers to use KX, GA, GY and GZ modifiers on oxygen claims. The KX modifier will indicate when payment criteria is met, and the GA, GY and GZ modifiers provide more information for oxygen claims that do not meet payment criteria.
Fee increase and beneficiary cost sharing noted as points to watch.
By Kristin Easterling
(May 10, 2018)—After months of advocacy from AAHomecare and other industry stakeholders, the Office of Management and Budget (OMB) and CMS have cleared the Interim Final Rule related to HME (CMS-1687-IFC) to increase fee schedule rates for certain DME items and services through 2018. Language in the recent Omnibus bill also urged the Administration to release the rule and move on relief for rural providers.
Strategy seeks to ensure individuals in rural America have access to high quality, affordable care.
WASHINGTON, D.C. (May 8, 2018)—Today, the Centers for Medicare & Medicaid Services (CMS) released the agency’s first Rural Health Strategy intended to provide a proactive approach on health care issues to ensure that the nearly one in five individuals who live in rural America have access to high quality, affordable health care.
Q&A with Pardee Home Health's administrative director
Budget and MedPAC recommend expansion, in spite of CMS evaluations.
WASHINGTON, D.C. (May 3, 2018)—United Spinal Association, United Ostomy Associations of America and Spina Bifida Association partnered with AAHomecare on a comprehensive white paper to articulate why competitive bidding should not include urologicals and ostomy supplies. The white paper counters recent references to expanding the controversial bid program in the President’s Budget and MedPAC recommendations.
These bodies provide accreditation and consultative services
Program updates aim to empower patients through better access while promoting interoperability.
WASHINGTON, D.C. (April 24, 2018)—The Centers for Medicare & Medicaid Services (CMS) proposed changes to empower patients through better access to hospital price information, improve patients’ access to their electronic health records, and make it easier for providers to spend time with their patients.
Follow-up RFI issued to gain additional insight.
WASHINGTON, D.C. (April 23, 2018)—The Centers for Medicare & Medicaid Services (CMS) announced that it has released the comments submitted by patients, clinicians, innovators and others in response to the CMS Innovation Center’s New Direction Request for Information (RFI).
2019 drug plans and policies have been finalized.
Via CMS, WASHINGTON, D.C. (April 3, 2018)—Today, the Centers for Medicare & Medicaid Services (CMS) finalized polices for Medicare health and drug plans for 2019 that will save Medicare beneficiaries money on prescription drugs while offering additional plan choices.
Home respiratory therapy patients have lost access to service under savings program.
WASHINGTON, D.C. (March 22, 2018)—The Council for Quality Respiratory Care (CQRC) today released a new report that highlights the urgent need for policymakers to reform Medicare’s outdated payment methodology. The report outlines how the current payment system, called the competitive bidding program (CBP), restricts patients’ access to the oxygen and medical equipment they need, despite the Centers for Medicare & Medicaid Services’ (CMS) best intentions.
Initiative's goal is to put patients at the center of the U.S. health care system.
Via CMS, WASHINGTON, D.C. (March 6, 2018)—Today, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma announced a new Trump Administration initiative—MyHealthEData—to empower patients by giving them control of their health care data, and allowing it to follow them through their health care journey.
Bundled payments demonstrated savings
Grace period for death or retirement restored.
Via AAHomecare, WASHINGTON, D.C. (February 28, 2018)—AAHomecare has been working for many months with CMS and the Jurisdiction D Council to fix a claims system problem related to physician’s PECOS enrollment.
AAHomecare releases spreadsheet of supporters of current legislative efforts.
Via AAHomecare, WASHINGTON, D.C. (February 22, 2018)—Champions on Capitol Hill remain highly engaged in efforts to roll back bidding-derived Medicare reimbursement cuts in rural/non-bid areas and to address the “double dip” cuts for oxygen in rural areas. With potential omnibus spending legislation expected in late March as a possible vehicle for language from H.R. 4229, it’s critical that we continue to engage Capitol Hill to support these priorities—especially over the next three weeks.
The panels examine the Quality Payment Program.
WASHINGTON, D.C.—CMS is soliciting nominations for technical expert panels (TEP) for its measure development and maintenance contractors. The project’s overall objective is to develop episode-based cost measures suitable for potential use in the Quality Payment Program.
Concerns over cuts and bid limits exist for rural providers.
Via AAHomecare, WASHINGTON, D.C. (February 14, 2018)—The recently released FY 2019 budget proposal from the White House includes several items related to DME. AAHomecare has especially strong concerns about the first item noted below and plans to talk to the Administration for clarification.
Provisions found in the budget proposal and an HHS summary document include:
Advocacy on Capitol Hill and beyond
The focus group looked at compliance and CMS requirements for providers.
WASHINGTON, D.C. (January 25, 2018)—Last Friday, AAHomecare attended the first Provider Compliance Focus Group meeting held at CMS’s main campus in Baltimore. This was an opportunity for Medicare stakeholders to engage in a conversation with CMS on a variety of compliance related issues. AAHomecare and several Regulatory Council members spoke to CMS on:
Tax on Medical Devices to Resume After 2-year Suspension
While much of corporate America will enjoy a tax cut in the new year, one industry is getting a tax increase it has fought hard, but so far unsuccessfully, to avoid. (Associated Press/CNBC)
States now have through December 31, 2018 to work out guidelines.
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.