AAHomecare submits comments on Stark Law, resupplies

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Thursday, August 23, 2018

WASHINGTON – AAHomecare emphasized the importance of coordinated care in its comments to CMS on possibly relaxing the Stark Law.

The Stark Law is designed to prevent physicians from ordering services and products for Medicare beneficiaries when the motivation is to make money.

In its comments, however, AAHomecare states that the Stark Law may “overly limit” healthcare providers—not only physicians but also HME providers, therapists (respiratory, physical and occupational), home health agencies and pharmacies—from coordinating care to treat beneficiaries more cost effectively.

“While it is important that the Medicare program encourage coordination, it is equally important that protection against fraud be maintained,” states AAHomecare. “This is a balancing act.”

AAHomecare also emphasized that a prohibition against allowing physicians to provide DME not listed in the “allowed products” category remain in place to ensure the infrastructure necessary to service beneficiaries; preserve beneficiary choice of products; and ensure accreditation standards are met.

The Department of Health and Human Services published a request for information, “Medicare Program: Request for Information Regarding the Physician Self-Referral Law” in June.

Association points to burdensome resupply requirements

AAHomecare also submitted comments to a June report from the Office of Inspector General that said most Medicare claims for CPAP supplies did not comply with requirements.

In a letter to Inspector General Daniel Levinson, the association pointed out that the local coverage determinations for CPAP are known for being one of the most complicated, with overly burdensome requirements.

While the OIG report cited proof of delivery issues in 36 out of 110 errors, AAHomecare pointed to the fact that CMS in recent months has provided guidance to allow additional flexibility. For example: The date of service on the claim can now be the ship date, the actual receipt date or the date the shipping label is printed, instead of the narrow definition of the date of service only being the ship date.

AAHomecare also suggested that the sample of 110 claims may not paint an accurate picture.

“In closing, AAHomecare would request the OIG to recommend that CMS continue to look at the overly burdensome nature of PAP supply requirements in an effort to work with the industry to ensure that beneficiaries have access to needed supplies for their sleep therapy,” it wrote.