Tag: Access

WASHINGTON - Industry stakeholders urge providers to comment on a proposal that would rescind certain Medicaid regulations regarding a state's obligation to assess and monitor beneficiary access when requesting approval to reduce or restructure payment rates.AAHomecare has submitted comments on CMS-2406-P2, “Medicaid Program; Methods for Assuring Access to Covered Medicaid Services-Rescission,” and NCART plans to.“This would be a major setback, dramatically minimizing the steps...

WATERLOO, Iowa - People for Quality Care has launched a survey for Medicare beneficiaries and family caregivers to measure their experiences getting durable medical equipment and supplies.The goal of the survey: to gauge the impact of Medicare changes, including national competitive bidding, on access to products and services.“Ensuring we understand the direct impact the changes being made by Medicare are having on consumers and caregivers is critical in helping us communicate their issues...

BUFFALO, N.Y. - NCART has developed a survey for suppliers and manufacturers to share information on reduced access to complex rehab technology at the hands of Medicaid managed care organizations. NCART seeks information where a Medicaid MCO has either inappropriately denied coverage of an item or established an inadequate payment amount for the item. The survey is part of a larger effort by NCART to develop a network of legal advocates and agencies to bring focus to MCO coverage and payment problems...

NEW YORK - A new report published in the December Annals of the American Thoracic Society highlights the problems many patients with lung disease experience in getting and using supplemental oxygen.In “Optimizing Home Oxygen Therapy: An Official American Thoracic Society Workshop Report,” 26 physicians, nurses, RTs, patients and patient advocacy groups, oxygen suppliers, and CMS and FDA officials detail the shortcomings of the current system of providing supplemental oxygen to 1.5 million...

NEW YORK - The amount of insulin required to treat Type 2 diabetes is expected to increase by more than 20% from 2018 to 2030, according to a new study published in The Lancet. Using data from the International Diabetes Federation, researchers developed a microsimulation of the Type 2 diabetes burden across 221 countries. The number of people worldwide with Type 2 diabetes is estimated to increase from 405.6 million in 2018 to 510.8 million in 2030. Insulin use is estimated to increase 616.1 million...

WATERLOO, Iowa - The VGM Group has added a study that shows the cost shift that is happening as a result of reduced access to DME for Medicare beneficiaries to its lobbying toolbox.The VGM-sponsored study by Leitten Consulting shows that:Fall-related injuries due to failure to provide needed mobility equipment results in a cost shift of between $4,705 and $5,029;COPD-related exacerbations due to failure to provide supplemental oxygen therapy results in a cost shift of about $14,350; andOSA-related...

WASHINGTON - Sens. Dan Coats, R-Ind., and Mark Warner, D-Va., have introduced a bill that they believe would help ensure that all Medicare beneficiaries have access to their preferred brand of diabetes test strips.The senators introduced the bill, the Diabetes Supplies Act, on Nov. 16 in response to Medicare's national mail-order program for diabetes testing supplies. As a result of the program, they say, the most commonly purchased brands of test strips are no longer available to Medicare beneficiaries...

I wrote a blog earlier this year about how competitive bidding has affected access to home medical equipment. I used our HME Databank to look at two data points for walkers (E0143), a common product that has been included in the program: the number of Medicare beneficiaries who received the product in a given year the amount Medicare spent on that product in a given year You'll recall that I found a 9% decrease in the number of Medicare beneficiaries who received walkers from 2012 to 2013 and a...

MARLBOROUGH, Mass. - The ReWalk exoskeleton system has been declared medically necessary by the Social Welfare Court of Speyer in Germany, announced ReWalk Robotics, the developer and manufacturer of the ReWalk. The ruling, delivered in July, states that the system should be covered by insurance for an individual with spinal cord injury, overturning the original denial of the claim by the payer, a statutory health insurance entity. "This ruling is a milestone for insurance coverage of exoskeleton...

WASHINGTON - The Office of Inspector General (OIG) has agreed to investigate the impact of competitive bidding on access to DME.Back in July, 137 lawmakers, including Rep. Tom Price, R-Ga., asked the OIG to conduct the study.“We plan to review documents from providers and Medicare claims data for a nationally representative sample of beneficiaries to determine and compare the rates at which beneficiaries successfully obtained needed items subject to competitive bidding,” Inspector General...