VGM calls on Price to take action

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Tuesday, March 21, 2017

WATERLOO, Iowa – The VGM Group outlined three priorities that need “immediate action,” including relief for HME providers rural areas, in a March 20 letter to Health and Human Services Secretary Tom Price.

The top priority: speeding up six months of payments owed to HME providers as part of a retroactive delay of reimbursement cuts that went into effect in non-competitive bidding areas on July 1, 2016. A provision in the Cures Act delayed the cuts until Jan. 1, 2017. CMS in February notified the DME MACs that they could begin dispersing payments on May 1, with implementation by July 3.

“This delay is unnecessary as more suppliers are forced to close their businesses on a weekly basis while waiting for payments on services provided nearly one year prior,” VGM stated in the letter.

The other two priorities: delaying these cuts to non-bid areas indefinitely, until an impact analysis is released; and correcting CMS’s application of two different statutes to determine payment methodologies for oxygen concentrators.

Additionally, VGM called on Price to reform the overall competitive bidding program; implement a broader prior authorization program to reduce audits; establish a separate benefit for complex rehab; and work with Veterans Affairs and Tricare to match their reimbursement rates to Medicare’s fee schedule.

“With the implementation of these proposed regulatory recommendations to the administration, we firmly believe that home medical equipment suppliers across the nation will have a renewed ability to provide care to the most vulnerable patients in the healthcare system,” the letter states.