Reach a growing market willing to pay for the products they want and need
Medicare
ATLANTA (September 6, 2018)—On January 1, 2019, any willing provider will be able to participate in the Medicare program, regardless of prior bidding “wins” or losses. What should providers do? Educational advisory board (EAB) members at Medtrade will outline all of the options, possible action, and consequences in a new educational track dubbed “The New Competitive Bidding.”
HARTFORD, Conn. (August 23, 2018)—CareCentrix announced that Leslie V. Norwalk has been elected to CareCentrix's board of directors. With health care experience spanning more than two decades, Norwalk will provide direction to help ensure CareCentrix's continued growth.
(August 13, 2018)—Since inception in March 2007, the 10 Medicare Fraud Strike Force units have charged more than 3,700 defendants who collectively have falsely billed the Medicare program for more than $14 billion, according to the Department of Justice (DOJ). A new force in the Newark, New Jersey and Philadelphia, Pennsylvania region has just been added.
WASHINGTON, D.C. (August 10, 2018)—The Centers for Medicare & Medicaid Services (CMS) has released a proposed rule to overhaul the Medicare Shared Savings Program. The program was established under the Affordable Care Act and launched in 2012. The majority of Medicare’s Accountable Care Organizations (ACOs) operate under the program.
(June 27, 2018)—The Integrated Care Resource Center (ICRC) recently released a briefing titled “Facilitating Access to Medicaid Durable Medical Equipment for Dually Eligible Beneficiaries in the Fee-for-Service System.” As the title states, the brief explores the approaches of Connecticut, California and Illinois in ensuring dual-eligible beneficiaries receive the medical equipment they need.
Background
LAS VEGAS (June 27, 2018)—The Medtrade Spring Call for Presentations is officially on, with organizers looking for speakers and panelists to lead educational sessions at the April 17–18, 2019, show at the Mandalay Bay Convention Center.
Are you willing to share successes and struggles? Are you an experienced provider who wants to help others succeed in this tough business? Are you an expert in your field who enjoys sharing wisdom in front of an audience?
LOUISVILLE, Ky. and DEERFIELD, Ill. (June 19, 2018)—Health and well-being company Humana Inc. and Walgreens, a provider of pharmacy services and care in communities since 1901, are teaming up to provide easier access to primary care and other services for seniors, as part of the companies’ ongoing and shared commitment to the health and well-being of the Kansas City community.
WASHINGTON, D.C. (June 17, 2018)—On June 15, 2018, the Medicare Payment Advisory Commission (MedPAC) issued its annual report to Congress.
MedPAC is recommending that more products be included in the Medicare competitive bid program. There are three categories of products MedPAC believes should be included:
(1) Items that Congress has already authorized to be included (e.g., chest wall oscillation devices, ventilators and off-the shelf orthotics)
WASHINGTON, D.C. (June 4, 2018)—On Friday, June 1, 2018, CMS released CMS-6080-N, “Medicare Program; Update to the Required Prior Authorization List of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Items That Require Prior Authorization as a Condition of Payment.”
The tools for detecting problems before the bubble up
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.
PITTSBURGH (April 24, 2018)—OnlyBoth Inc. announced the launch of its no-cost home health agency benchmarking engine, which applies innovative artificial intelligence (AI) technology to Medicare data previously gathered about providers. The unique engine delivers text-based insights so users can easily compare and contrast home health agency performance for informed decision-making.
Model draws blueprint around effective care delivery and spending improvements
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.
Superior HealthPlan re-evaluates planned cuts to services.
AUSTIN, Texas (March 6, 2018)—Dozens of medical equipment suppliers in Texas rallied together to successfully prevent proposed reimbursement cuts by Superior HealthPlan. The cuts, which suppliers were notified of in a letter received in early February, would have been substantially lower than Texas state Medicaid, reducing rates for certain product categories from 85 percent of Texas Medicaid to 60 percent, with a few suppliers receiving a reduction to 65 to 70 percent.
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.
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