Hospitals take up CMS on offer

Will HME providers get their chance?
Thursday, June 18, 2015

WASHINGTON – Recent settlements of pending appealed claims between CMS and hospitals have given stakeholders hope that a settlement with HME providers is also possible.

As of June 1, CMS has paid $1.3 billion from the Medicare Trust Fund to settle 300,000 pending appealed claims from more than 1,900 hospitals, according to an update.

Back in August, CMS offered “an administrative agreement to any acute-care hospital or critical access hospital willing to resolve their pending appeals (or waive their right to request an appeal) in exchange for timely partial payment (68% of the net payable amount).”

CMS made the offer to help break a logjam at the Office of Medicare Hearings and Appeals.

Stakeholders have been in talks with OMHA on settlement options more geared toward HME providers.

“The current settlement options offered by OMHA are not appealing to the DMEPOS industry based on strict criteria that OMHA has established to be eligible,” AAHomecare stated in a bulletin this week.

Stakeholders hope options for HME providers will be a talking point during an OMHA conference call on June 25 to discuss updates on its initiatives.