Tag: Reimbursement cuts

Minnesota Gov. Tim Walz has released budget recommendations for 2020 and 2021 that include reimbursement cuts for DME, MAMES reports. Walz proposes changing “the medical assistance reimbursement formula for durable medical equipment that is also covered by Medicare to pay equivalent to the Medicare rate…This would reduce payment for DME starting in FY 2019 and reduce the value of recoveries in the forecast starting in FY 2021.” Walz also proposes simplifying reimbursement for products...

It's always disappointing when the HME industry's efforts to get relief from Medicare's competitive bidding program fail to cross the finish line. But this last time around, when H.R. 4229 failed to make the cut in a recently passed omnibus bill, it was particularly disappointing. In the weeks leading up to the vote on the omnibus bill, I received emails from several providers asking, do you think it will happen? After the vote, the “ask” became, do you think it will ever happen? I offered...

In December 2016, Congress passed wide-ranging healthcare legislation popularly known as the Cures bill that expedited the implementation of a requirement that the federal portion of Medicaid reimbursement to states for HME cannot exceed what Medicare would have allowed for these items, in aggregate, beginning on Jan. 1, 2018. CMS provided its first update to Medicaid directors via a webinar in December, but it failed to include information needed for states to understand how to implement the new...

HARTFORD - The Connecticut Department of Social Services has published a bulletin outlining its plans to reduce reimbursement rates for HME, supplies, O&P and complex rehab by 50% to 60% on April 1, according to the Home Medical Equipment and Services Association of New England. HOMES, in collaboration with AAHomecare and NCART, is planning a multi-pronged approach to fighting the cuts, first with a survey of providers in the state. The provider survey, which closes March 9, asks for information...

WASHINGTON - CMS has given state Medicaid directors more “open-ended guidance” for complying with a provision in the 21st Century Cures Act, AAHomecare reported Jan. 5.In a Jan. 4 letter, CMS states: "States electing to submit an aggregate payment comparison, or an alternative approach to compliance as mentioned earlier in this letter, will work with CMS to determine the best approach to calculate the FFP limit for their state using expenditures for the period of January 1, 2018, through...

REDDING, Calif. - Northern Rehab Equipment & Respiratory is closing its doors after 19 years in business, according to a local newspaper. The HME provider served customers all over the North State, specializing in products for the elderly like beds, wheelchairs, walkers, oxygen concentrators, diabetic shoes and more. Owner Stephanie Schwartz told the newspaper that her company maintained a steady clientele but decreases in Medicare reimbursement made the business too difficult. New West Medical,...

OKLAHOMA CITY, Okla. - The Oklahoma Health Care Authority has had to map out budget scenarios for the upcoming fiscal year based on a 5% to 15% reduction in state appropriations, according to Tulsa World. A cut of 15% would mean eliminating some optional benefits and reducing provider rates by up to 25%. Benefits being evaluated for elimination include pharmacy, behavioral health and DME, according to the newspaper. Past budget shortfalls have resulted in eliminating or reducing sleep studies, perinatal...

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...

GOLETA, Calif. - Inogen expects to recoup up to $2 million in rental revenues for the fourth quarter of 2016 as a result of a provision in the recently passed 21st Century Cures Act. The provision requires CMS to retroactively delay a second round of reimbursement cuts in non-competitive bidding areas from June 30, 2016, to Dec. 31, 2016. The company based its estimate on preliminary, unaudited financial data, it said in a press release. “We are pleased that the Cures Act reverses some...

WASHINGTON - CMS on Wednesday announced the contract suppliers for the latest round of its competitive bidding program.For Round 1 2017, CMS says it has executed 182 contracts, 92% of the contracts it offered. The contracts will run from Jan. 1, 2017, through Dec. 31, 2018.CMS says 92% of the contract suppliers are already established in the competitive bidding area, the product category, or both. It says 93% of small suppliers, those with gross revenues of $3.5 million or less, accepted offers.Contract...