AAH paper makes case for preserving Medicaid rates

Thursday, February 9, 2017

WASHINGTON – AAHomecare has released a briefing paper designed to help HME providers engage state Medicaid programs now that a new law has been passed that limits the federal contribution for HME to these programs to the Medicare rates starting Jan. 1, 2018. The paper, “States Should Not Accept Flawed Medicare Rates,” notes the unsustainable rates facing providers operating under competitive bidding-derived Medicare rates and provides perspectives on the problems with applying these rates to state Medicaid programs. The paper focuses on four arguments: 1) the distinct patient populations and differing missions of Medicare vs. state Medicaid programs; 2) the defective and unsustainable Medicare bidding program; 3) major differences in reimbursement structure between the two programs; and 4) significant geographic variances in patient populations that Medicare rates do not adequately account for. AAHomecare argues “there is no federal requirement for a state Medicaid program to tie its payment limits to Medicare rates,” and that states are, in fact, directed to set their own rates as needed to maintain beneficiary access and a sufficient number of participating providers.