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Tag: Kim Brummett


CMS sunsets CMN for home oxygen

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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...

aahomecare, CMN, home oxygen NCD, Kim Brummett, Ronda Buhrmester, VGM


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The case for relief in former bid areas 

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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 –...

aahomecare, Home Medical Equipment, Kim Brummett


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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...

aahomecare, Kelly Grahovac, Kim Brummett, The van Halem Group


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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...

Andrea Stark, Kim Brummett, Performant Recovery, RAC audits, Wayne van Halem


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Specialty Providers

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...

aahomecare, Andrea Stark, Kim Brummett, MiraVista, ResMed, ventilators


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Specialty Providers

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...

aahomecare, K&L Gates, Kim Brummett, Stephen Cooper, ventilators


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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 on...

aahomecare, Andrea Stakr, Cara Bachenheimer, Kim Brummett, rural areas


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Stakeholders bring discharge planners into the loop

March 13, 2015Theresa Flaherty, Managing Editor

WASHINGTON - Industry stakeholders are counting on the support of healthcare professionals from outside the DME arena to bolster their arguments against competitive bidding.“We know that lawmakers need to hear from some other people that are affected by the program who don't have a vested interest,” said Karyn Estrella, executive director of the Home Medical Equipment Services Association of New England. “We know that the beneficiaries are not calling and complaining at the numbers...

aahomecare, Discharge Planners, Karyn Estrella, Kim Brummett


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WOPD requirement still problematic

January 30, 2015Liz Beaulieu, Editor

WASHINGTON - CMS has been enforcing the written order prior to delivery (WOPD) requirement for a year now, but compliance is still a road filled with potholes for many HME providers, industry stakeholders say.One big reason, says AAHomecare's Kim Brummett: The DME MACs are requiring more than the minimum five elements outlined in the Affordable Care Act (ACA): beneficiary name, DME item ordered, prescribing practitioner's NPI number and signature, and date of order.“The MACs all say providers...

Andrea Stark, Kim Brummett, WOPD


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Industry presses for details on bundling

November 26, 2014Theresa Flaherty, Managing Editor

WASHINGTON - Industry stakeholders are seeking answers to a laundry list of questions regarding CMS's “incredibly vague” plan to bundle payments for standard power wheelchairs and CPAP.“We've posed several questions already and will submit about a dozen more,” said Kim Brummett, senior director of regulatory affairs for AAHomecare. “CMS has indicated they are compiling the questions and will respond to the industry. CMS knows the bundling thing is incredibly vague.”Among...

Bundling, Cara Bachenhiemer, Kim Brummett


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