HME providers testify at SBA hearing

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Thursday, August 22, 2019

WASHINGTON – Managed care plans, CRT reimbursement and coverage for breast prosthesis topped the list of concerns HME providers shared at an Aug. 19 Small Business Administration Regulatory Fairness Hearing.

Provider Georgie Blackburn said she’s seen a significant impact on small businesses under Pennsylvania’s managed care model for Medicaid, according to a bulletin from VGM.

“We have witnessed significant barriers to access for recipients in need for durable medical equipment,” said Blackburn. “We have experienced a growing accounts receivable for services authorized and provided. Having contracted with all MCOs in our state, we can compare the effectiveness, efficiencies, and, most importantly, the timeliness of care. MCOs simply do not operate in a similar manner, and states do not effectively monitor comparable activity.”

Provider John Letizia told SBA board members that Medicare reimbursement for CRT accessories is affecting his ability to provide service to power wheelchair users.

Jasmine Jones of Cherry Blossom Intimates and Nikki Jensen of Essentially Women spoke about the importance of requiring Medicare coverage of custom breast prostheses.

The SBA hearings are held regionally around the country and HME providers have regularly testified on industry issues.