WASHINGTON, D.C. (June 23, 2016)—CMS released a final rule implementing Section 216(a) of the Protecting Access to Medicare Act of 2014 (PAMA), requiring laboratories performing clinical diagnostic laboratory tests to report the amounts paid by private insurers for laboratory tests. Medicare will use these private insurer rates to calculate Medicare payment rates for laboratory tests paid under the Clinical Laboratory Fee Schedule (CLFS) beginning January 1, 2018.
CMS
LENEXA, Kan. (June 16, 2016)—Mediware Information Systems, Inc., is hosting a free webinar for attendees Wednesday, June 29, at 2 p.m. CST (3 p.m. EST) to discuss how to successfully grow your business through marketing strategies while staying within the law. The webinar is titled “Health Care Marketing Compliance 101: Protecting Your HME/DME from the OIG and DOJ,” presented by Matthew Agnew and Stephen Angelette of Polsinelli Health Care Regulatory Associates.
CMS Launches Home Health Prior Authorization Requirement
Despite pushback from the home health industry and lawmakers, the Centers for Medicare & Medicaid Services (CMS) announced Wednesday it intends to move forward with a preauthorization requirement. (Kourtney Liepelt/Home Health Care News)
WASHINGTON, D.C. (June 9, 2016)—The Partnership for Quality Home Healthcare—a coalition of home health providers dedicated to improving the integrity, quality and efficiency of home health care for our nation's seniors—today expressed disappointment with the revised home health prior authorization demonstration released today by the Centers for Medicare & Medicaid Services (CMS).
WASHINGTON, D.C. (June 9, 2016)—When the Medicare program implements changes to how it pays for medical care or equipment, CMS monitors to make sure that any adjustments meet our goals of preserving access to care and facilitating better health outcomes for Medicare beneficiaries.
WASHINGTON, D.C. (June 9, 2016)—The Centers for Medicare & Medicaid Services (CMS) today released a final rule improving how Medicare pays Accountable Care Organizations in the Medicare Shared Savings Program for delivering better patient care. Medicare is moving away from paying for each service a physician provides towards a system that rewards physicians for coordinating with each other.
WASHINGTON, D.C. (June 9, 2016)—The Council for Quality Respiratory Care (CQRC)—a coalition of the nation’s leading home oxygen therapy provider and manufacturing companies—commended lawmakers in the House Ways & Means Health Subcommittee for reviewing legislation to sustain and improve the Medicare program, including the Patient Access to Durable Medical Equipment Act (PADME).
WASHINGTON, D.C. (June 8, 2016)—A newly released GAO report, “Medicare: Utilization and Expenditures for Complex Wheelchair Accessories,” was presented to Congress on June 1, 2016, just 30 days before prices derived from CMS’s flawed bidding program for home medical equipment are set to take effect for specialized complex rehab technology (CRT) wheelchairs used by individuals with profound mobility and disability challenges.
WASHINGTON, D.C. (June 2, 2016)—The count is at 30 days until the July 1 cuts take effect, and AAHomecare is calling the HME community to commit to making every last effort to encourage Congress to support legislation for rural relief—The Patient Access to Durable Medical Equipment (PADME) Acts, H.R. 5210 and S. 2736.
DALLAS (June 1, 2016)—Rising numbers of retirees and excess cost growth have made it imperative that changes be made to Medicare’s financing—or the cost burden will crush taxpayers, according to a new study by NCPA Senior Fellows Andrew J. Rettenmaier and Thomas R. Saving.
WASHINGTON, D.C. (May 27, 2016)—The Council for Quality Respiratory Care (CQRC)—a coalition of the nation’s leading home respiratory therapy providers and manufacturing companies—warned that findings released from the Department of Health and Human Services (HHS) Office of the Inspector General (OIG) signal fundamental flaws in the competitive bidding rate setting process for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS).
WASHINGTON, D.C. (May 26, 2016)—The Office of the Inspector General (OIG) for the Department of Health & Human Services today released a report that raises more concerns about the Centers for Medicare & Medicaid Services’ (CMS) ill-conceived competitive bidding program for home medical equipment.
WASHINGTON, D.C. (May 26, 2016)—A group of national and state associations sent a letter to Congressional leaders today urging passage of the Patient Access to Durable Medical Equipment Act of 2016 (S.2736 and H.R. 5210), bipartisan legislation that would ensure continued patient access to vital health care technology.
WASHINGTON, D.C. (May 26, 2016)—Some contract suppliers in Round 2 of the Durable Medical Equipment Competitive Bidding Program had not met all of the competitive bidding licensure requirements. Specifically, of the 146 suppliers covered in our audit, 69 suppliers met licensure requirements. However, 63 suppliers did not meet licensure requirements for some of the competitions for which they received a contract.
WASHINGTON, D.C. (May 24, 2016)—CMS’s recently published statement on Medicare assignment rate information is grossly inadequate for evaluating the impact of the first round of deep competitive-bidding derived pricing cuts on patients in rural and non-bid areas. CMS’s report is vague and fails to provide important details:
WASHINGTON, D.C. (May 18, 2016)—The Council for Quality Respiratory Care (CQRC) today cautioned that data released from the Centers for Medicare & Medicaid Services (CMS) do not fully reflect the true impact of Medicare cuts recently imposed on Durable Medical Equipment, Prosthetics, Orthotics & Supplies (DMEPOS), including home-based respiratory therapies.
WASHINGTON, D.C. (May 18, 2016)—Starting in 2011, section 1834(a)(1)(F) of the Social Security Act (the Act) required CMS to use competitive bidding to set payment amounts for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) for certain areas in the country.
WASHINGTON, D.C. (May 13, 2016)—The Partnership for Quality Home Healthcare—a coalition of home health providers dedicated to improving the integrity, quality, and efficiency of home health care for our nation's seniors—recently expressed deep concern regarding the Centers for Medicare & Medicaid Services’ (CMS) proposal to require the prior authorization of Medicare home health services.
Washington, D.C. (May 12, 2016)—The highly anticipated companion bill to S. 2736, the Patient Access to Durable Medical Equipment (PADME) Act, was introduced in the House of Representatives on Thursday, May 12, 2016. H.R. 5210 was introduced by Representatives Tom Price, M.D. (R-Ga.) and Dave Loebsack (D-Iowa). This bill has gathered broad bi-partisan support as it has been introduced with 40 original co-sponsors including Reps.
WASHINGTON, D.C. (May 12, 2016)—Today CMS published a revision to SE1521, which places limits on the scope of review for redeterminations and reconsiderations of certain claims. When this was originally published in 2015, AAHomecare worked with CMS to have the instruction expanded to include complex prepayment audits.
This should be helpful as suppliers work through the audit and appeal process!