ALBANY, N.Y. (March 17, 2022)—The American Association for Homecare (AAHomecare) is working with the North East Medical Equipment Providers Association (NEMEP) on legislative efforts to pass rate floor bills in the New York state legislature that would require Medicaid managed care organizations to pay at least 100% of the state Medicaid fee schedule.
Medicaid
DENVER (March 4, 2022)—The Justice Department has concluded that the state of Colorado unnecessarily segregates people with physical disabilities in nursing facilities, in violation of the Americans with Disabilities Act (ADA) and the Supreme Court’s decision in Olmstead v. L.C. The department’s findings, detailed in a letter to Colorado Governor Jared Polis, follow a thorough and multi-year investigation into the state’s system of care for people with physical disabilities.
Get your team ready for a possible feeding frenzy
WASHINGTON, D.C. (February 1, 2022)—The National Association for Home Care & Hospice (NAHC) has joined a large group of likeminded organizations in urging leaders in both houses of Congress and both parties to ensure that Medicaid Home and Community Based Services (HCBS) remain part of any package that moves forward.
TALLAHASSEE, Fla. (January 28, 2022)—BAYADA Home Health Care Inc. is laying off nearly 700 employees in the state of Florida.
Notices went out Monday, Jan. 24, to the impacted employees, with layoffs effective as of April 1, 2022.
The company is closing its Assistive Care State Program, part of the state’s Medicaid home health program, eliminating 12 job positions and 682 employees.
An argument for expanding, not curtailing, the benefit
LANSING, Mich. (Nov. 18, 2021)—Amy Bassano, former deputy director for the Center for Medicare and Medicaid Innovation (CMMI) at the Centers for Medicare and Medicaid Services, has joined national healthcare consulting firm Health Management Associates (HMA), taking the helm as a managing director of Medicare services.
JACKSON, Miss. (October 28, 2021)—Mississippi home medical equipment (HME) stakeholders secured a significant measure of relief when the state’s legislature eliminated a long-standing 5% reduction in Medicaid rates for HME, effective July 1, 2021.
WASHINGTON, D.C. (October 21, 2021)—The Centers for Medicare & Medicaid Services (CMS) has launched a new “one-stop shop” for state Medicaid agencies and stakeholders on medicaid.gov to advance transparency and innovation for home- and community-based services.
ANKENY, Iowa (September 28, 2021)—When individuals with complex health needs receive clinically appropriate, home-delivered meals for 13 weeks, their overall medical spend and emergency department use significantly decreased for the next six months, according to just-released results of a pilot program between Mom’s Meals and UPMC Health Plan’s Medicaid physical health managed care plan, UPMC for You.
RALEIGH, N.C. (September 16, 2021)—North Carolina Medicaid has agreed to extend the 5% Medicaid rate increase granted to help home medical equipment (HME) suppliers respond to the COVID-19 public health emergency (PHE) for an additional two months. The agency had discussed ending the increase for HME on Sept. 30, 2021; it will now remain in place through Nov. 30, 2021.
4 insights to help your organization make this crucial change
OAKLAND (August 26, 2021)—California Attorney General Rob Bonta announced a $3.31 million settlement against home respiratory services company, SuperCare Health Inc. (SuperCare) for defrauding the state and federal government by knowingly billing Medicare and Medi-Cal for servicing ventilators that were no longer medically necessary.
WASHINGTON, D.C. (August 19, 2021)—Stakeholders representing health care providers and end users with medical needs developed a white paper to educate payers and state Medicaid programs on the types of products and services needed to successfully manage an individual’s bowel and bladder needs in a home-based setting to achieve the Triple Aim of improving patient experience and health outcomes while reducing overall cost.
WASHINGTON, D.C. (July 30, 2021)—The American Association for Homecare’s (AAHomecare) payer relations team has been working with leaders at state and regional associations to direct relief from the March 2021 American Rescue Plan Act (ARPA) to the home medical equipment (HME) community. Those efforts bore their first fruit last week when MassHealth included a 10% Medicaid rate hike for HME as part of their plans to allocate Massachusetts’ share of the funds.
BOSTON (July 22, 2021)—The MassHealth Medicaid program is implementing a 10% rate increase for durable medical equipment (DME) claims with dates of service effective July 1, 2021. The broad-based relief applies a 10% increase for all DME and augmentative and alternative communications codes and a 50% increase for labor code K0739, which covers repair or nonroutine service for DME other than oxygen equipment requiring a skilled technician.
RALEIGH, N.C. (July 8, 2021)—North Carolina home medical equipment (HME) suppliers closed a loophole that could have weakened Medicaid managed care organization (MCO) rate floor policy and in addition were able to secure an extra two years of protections through recent action in the North Carolina Legislature.
MENLO PARK, California (June 24, 2021)—The Biden administration is quietly engineering a series of expansions to Medicaid that may bolster protections for millions of low-income Americans and bring more people into the program.
Biden’s efforts — which have been largely overshadowed by other economic and health initiatives — represent an abrupt reversal of the Trump administration’s moves to scale back the safety-net program.
OKLAHOMA CITY (June 11, 2021)—Oklahoma home medical equipment (HME) suppliers and a broad spectrum of other health care providers were cheered last week by a state Supreme Court ruling that the Oklahoma Health Care Authority (OHCA) does not have the authority to implement a managed care plan for the state’s Medicaid system.