Tag: 21st Century Cures Act

WASHINGTON - Sens. Mark Warner, D-Va., and Tim Scott, R-S.C., have introduced legislation that uses technical clarifications to remove the requirement that a nurse or other health care professional be present in the patient’s home for the home infusion provider to be paid for those services.  The Preserving Patient Access to Home Infusion Act also incorporates the full scope of professional services provided through home infusion — including essential pharmacist services —...

ST. PAUL, Minn. – The Minnesota Department of Human Services has temporarily suspended its plans to recoup payments where the state Medicaid program paid more for DME than Medicare did in 2018 per the 21st Century Cures Act, MAMES reports. In December, the state association received a letter from the state saying, “DHS has temporarily suspended our processes for these recoveries.” MAMES believes the pause is due to the current public health emergency. “There...

SACRAMENTO, Calif. - California's Medicaid program, Medi-Cal, may find itself in a bind for HME providers if a drastic reimbursement cut goes through as planned, say industry stakeholders.To comply with the 21st Century Cures Act, the Department of Health Care Services has proposed paying 80% of Medicare's non-rural fee schedule amounts for most DME. For providers in the state, who are currently reimbursed at the 2016 Medicare fee schedule amounts, that's a cut of up to 60%. “From what I'm...

WASHINGTON - With little time to make an informed decision, an increasing number of states, including Georgia, Indiana and Washington, are planning to adopt Medicare reimbursement for certain DME to comply with a provision in the 21st Century Cures Act.CMS finally published a letter to state Medicaid directors on Dec. 27 with guidance on the provision—which requires CMS to cap its contribution to Medicaid reimbursement for certain DME at Medicare reimbursement—just three business...

WASHINGTON - CMS has finally started to detail how it plans to implement a provision in the 21st Century Cures Act that requires the agency to cap its contribution to Medicaid reimbursement for DME at Medicare reimbursement starting Jan. 1, 2018.CMS on Nov. 28 published a notice in the Federal Register outlining its plans to require state Medicaid programs to submit their fee schedules for K, E and select A codes using a new spreadsheet to make sure they're not paying too much for DME.“They...

WASHINGTON - Suppliers won't need to resubmit claims to get retroactive payment adjustments mandated by the 21st Century Cures Act, according to guidance released today by CMS.The Cures Act, signed into law in December, rolled back cuts that went into effect in non-competitive bidding areas from June 30, 2016, to Dec. 31, 2016, allowing providers in those areas to recoup six months worth of payments.In guidance released to the DME MACs, CMS said it will recalculate the fee schedule to extend the...

WASHINGTON - President Barack Obama on Dec. 13 signed into law the 21st Century Cures Act, which offers some relief to HME providers in rural areas.The bill, passed by the House of Representatives on Nov. 30 and the Senate on Dec. 7, will retroactively delay Medicare cuts that went into effect in non-competitive bidding areas from June 30, 2016, to Dec. 31, 2016, allowing providers to recoup six months worth of payments.The same cuts will go back into effect, however, on Jan. 1, 2017.Still, industry...

WASHINGTON - Now that a rollback of a second round of Medicare reimbursement cuts in rural areas is a foregone conclusion, the big question is: How will CMS follow through on Congress' directive?At press time on Friday, the 21st Century Cures Act was on its way to a supportive president for his signature, after sailing through the House of Representatives on Nov. 30 and the Senate on Dec. 7. The huge bill will, among many other things, roll back cuts that went into effect in non-competitive bidding...

WASHINGTON - The HME industry is within spitting distance of rolling back certain Medicare reimbursement cuts after the 21st Century Cures Act sailed through the House of Representatives last week.The legislation, which passed Nov. 30 by a vote of 392 to 26, would roll back a second round of Medicare reimbursement cuts that went into effect this year in non-competitive bidding areas from June 30, 2016, to Dec. 31, 2016. But the cuts would again go into effect on Jan. 1, 2017.“Obviously, we...

WASHINGTON - The House of Representatives yesterday passed the 21st Century Cures Act, which includes important HME-related provisions, by a margin of 392 to 26.The legislation would roll back a second round of Medicare reimbursement cuts that went into effect this year in non-competitive bidding areas from June 30, 2016, to Dec. 31, 2016. It would also further delay Medicare's plan to use bidding-derived prices for accessories for complex power wheelchairs until July 1, 2017.“This is a great...