AAH makes Medicare, Medicaid policy recommendations

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Thursday, March 19, 2020

WASHINGTON – AAHomecare is urging CMS to cut through “red tape” to ensure patients diagnosed with COVID-19 have access to necessary home respiratory services.

In a letter to CMS Administrator Seema Verma, the association says HME providers are “uniquely qualified” to assist during the coronavirus outbreak.

“The current COVID-19 outbreak presents many challenges to our health care system,” the letter states. “If the virus spreads and hospitals reach capacity, we will see an increased need for treatment of people at home, including those directly related to COVID-19.”

Among the asks AAHomecare is requesting from CMS:

Delay the implementation of the competitive bidding program for one year; and suspend all audits to allow suppliers to focus on emergency activities.

Pay for equipment, supplies and services for patients with a confirmed COVID-10 diagnosis; and provide coverage for short-term oxygen for beneficiaries with acute conditions to ease hospital overflow.

Waive the requirement for a face-to-face visit to assist with social distancing efforts.

Allow alternatives for proof of delivery requirements. That could include a technician photographing equipment on the porch to validate receipt.

Allow an extension of the expiration date of written orders for an additional nine months from the date orders currently expire for recurring supply orders and ongoing DME rentals.

The association is also asking CMS to: suspend certain supplier standards, including minimum hours of operation and to allow use of one or more cell phone numbers in lieu of a primary business telephone; and designate DMEPOS suppliers as essential services to allow delivery to quarantined areas.

Payer relations creates list of Medicaid policy recommendations

AAHomecare’s payer relations team met with the National Association of Medicaid Directors to collaborate on policy changes and guidance for messaging nationwide.

The recommendations for state and other payers are in line with those for Medicare, with a few additional recommendations:

Waive prior authorization requirements for exceeding quantity limitations on gloves, incontinence, urological, ostomy, oxygen, suction, ventilators, enteral, and wound care supplies.

Allow in-home sleep testing through an independent testing facility (IDTF) to qualify beneficiaries for PAP devices.  

Allow prescribers not currently enrolled in Medicaid programs to order DMEPOS.

The payer relations team is also reaching out to top commercial payers. It will continue to monitor and make additional recommendations.