Tag: Kim Brummett
Home oxygen therapy: Stakeholders welcome ‘much-needed’ guidance
March 3, 2023Theresa Flaherty, Managing Editor
WASHINGTON – An updated FAQ published by the DME MACs in February, by and large, addresses concerns around the new local coverage determination for home oxygen therapy and serves as a good reference point as HME providers navigate a new era for the benefit, stakeholders say.
The FAQ, published Feb. 21 and updated Feb. 23, addresses 25 questions related to continued need, the new N modifiers and more.
“Full stop, it was a much-needed thing,” said Andrea Stark, a...
‘There needs to be a way to recognize a patient as being part of PHE’
May 13, 2022Liz Beaulieu, Editor
WASHINGTON – Industry stakeholders are trying to guide what a post-PHE world for home oxygen therapy and other product categories might look like.
AAHomecare recently discussed with CMS a one-page recommended reference document for Medicare audit contractors reviewing claims for dates of service during and after the PHE. The document is a cheat sheet of sorts for the waivers that have been in place during the PHE that don’t require, for example, medical documentation or a signature.
“It...
CMS sunsets CMN for home oxygen
October 1, 2021Theresa Flaherty, Managing Editor
WASHINGTON – CMS on Sept. 27 posted a final national coverage determination for home oxygen, but now industry stakeholders must “wait and see” what the DME Medicare Administrative Contractors do with the changes.
While the effective date of the NCD is technically Sept. 27, it won’t be implemented until a later date, when the DME MACs update their local coverage determinations.
“There are a lot of positives here, and we will wait and see,” says...
The case for relief in former bid areas
January 8, 2021Liz Beaulieu, Editor
WASHINGTON – In recent comments to CMS’s DMEPOS proposed rule, AAHomecare introduced the idea of a 90/10 blended reimbursement rate in the former competitive bidding areas. Here’s what Kim Brummett, vice president of regulatory affairs for the association, had to say about what stakeholders hope will be a “reasonable” ask – to base rates in those areas 90% on the current rates and 10% on the 2015 unadjusted fee schedule –...
Is e-prescribing at a stalemate?
January 10, 2020Liz Beaulieu, Editor
WASHINGTON - AAHomecare's Kim Brummett and a group of providers recently briefed a CMS contractor on why there isn't greater adoption of e-prescribing platforms for HME.
“They didn't understand what the challenges are, so it was eye opening,” said Brummett, vice president of regulatory affairs for AAHomecare. “If they can impart to CMS what those are, that might help further adoption.”
The CMS contractor, Scope Infotech, a CMS Strategic Partners Acquisition...
Patients Over Paperwork: Room for improvement for HME
October 5, 2018Liz Beaulieu, Editor
WASHINGTON - Much has been made of CMS's plans to reduce the paperwork burden for healthcare providers, but what about for HME providers, specifically?The agency's most recent attempt was last month, when it released a proposed rule aimed at removing unnecessary, obsolete or excessively burdensome Medicare compliance requirements. The rule, however, focused on Part A.“There was nothing in the rule for us,” said Kim Brummett, vice president of regulatory affairs for AAHomecare. “We...
Providers prep for return of RAC
November 18, 2016Liz Beaulieu, Editor
LIVERMORE, Calif. - Providers should strap in: After a protracted lull, RAC audits will likely pick back up in January, now that CMS has tapped Performant Recovery, based here, to perform post-payment reviews for DME and home health/hospice claims nationwide.
Stakeholders say Performant will likely kick-start its efforts with reviews* it had previously been performing as the RAC for Jurisdiction A—reviews whose targets were everything from vacuum erection devices to respiratory assist devices...
MACs remove 'imminent death' requirement for vents
May 13, 2016Theresa Flaherty, Managing Editor
WASHINGTON - Recent guidance from the DME MACs on coverage criteria for ventilators is a move in the right direction, say industry stakeholders.Specifically, the guidance removes the so-called “imminent death requirement,” which stated that patients must need a ventilator 24/7 for coverage.It's a requirement the MACs issued in April 2015 in an attempt to define criteria for vents vs. bi-level devices.The new guidance doesn't go that far, but “makes very clear that any device which...
Stakeholders draft legislation to fight vent changes
February 26, 2016Theresa Flaherty, Managing Editor
WASHINGTON - CMS needs to dial back the wholesale changes it has made to ventilators with little input from the industry, stakeholders say.In January, CMS switched from five ventilator codes to two, and reduced reimbursement by about 33%.“When they are creating codes, providers should have some role in that,” said Stephen Cooper, counselor at K&L Gates, a law firm representing about 30 providers. “Right now, it's somewhat of a black box approach.”K&L Gates has drafted legislative...
Nat'l roll out starts to take shape
October 9, 2015Liz Beaulieu, Editor
WASHINGTON - All eyes last week were on CMS's preliminary list of rural zip codes for the national roll out of competitive bidding, with HME providers doing business in those areas set to feel a little less of a cut.
CMS plans to implement bid pricing nationwide on Jan. 1, 2016, with separate fee schedules for regional and rural areas. For regional areas, the agency will base pricing on the average pricing in the competitive bidding areas in the region; for rural areas, it plans to base pricing...