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...

INDIANAPOLIS - Medicaid officials in Indiana have halted their plans to adopt the lowest Medicare rates, VGM reports. On Nov. 6, officials met in person with several members of the Great Lakes Home Medical Services association and HME providers in the state, along with representatives from VGM, AAHomecare and NCART, as a first step toward collaborating on fee schedule changes. In September, the state announced plans to adopt the lowest Medicare rates starting Oct. 1 to comply with the 21st Century...

WASHINGTON - HME providers in California and Indiana have recently received reprieves from steep Medicaid cuts, but the discussion is going to be ongoing in those states and others as Medicaid programs still try to comply with the 21st Century Cures Act. Per the Cures Act, passed in late 2016, the federal portion of Medicaid reimbursement for HME cannot exceed what Medicare allows. States can either base their Medicaid rates on Medicare's lowest fee schedule; or they can gather aggregated...

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...

SAINT PAUL, Minn. - A meeting in early February between HME stakeholders and Minnesota Medicaid officials on how to comply with a provision in the 21st Century Cures Act that requires Medicaid reimbursement not to exceed Medicare allowables ended in a stalemate. The state had initially sought input from HME stakeholders on its plan to implement a “claw back” for payments stretching back to Jan. 1, 2018. “It was determined that we would no longer discuss Cures for we weren't...

WASHINGTON - The past year has been a busy one for AAHomecare's Laura Williard: She met with 28 states about Medicaid rates. 2019 is shaping up to be just as busy, she says. Per the 21st Century Cures Act, passed in late 2016, the federal portion of Medicaid reimbursement for HME cannot exceed what Medicare allows. States can either base their Medicaid rates on Medicare's lowest fee schedule; or they can gather aggregated data using their Medicaid rates and utilization rates by area...

AAHomecare submitted two letters to Health and Human Services and CMS officials this week. The first letter detailed long-term reforms for the competitive bidding program and highlighted seven priority recommendations that the association would like to see incorporated into the next round of the program. The second letter was a response to the President's Budget for FY2019 and identified seven proposals that would impact the HME industry, the most concerning of which being expanding the bid process...

WASHINGTON - Complex rehab stakeholders seek signatures for a letter to CMS asking the agency not to apply a provision in the 21st Century Cures Act to complex rehab technology. Stakeholders are collecting signatures for the letter*, spearheaded by Reps. Bill Johnson, R-Ohio, and Robert Latta, R-Ohio, until May 17. A provision in the Cures Act requires CMS to limit federal contributions to Medicaid reimbursement to competitive bidding-influenced Medicare reimbursement. Stakeholders argue that,...

WASHINGTON - The Medicaid programs of 11 states have indicated that they will be changing their fee schedules to match Medicare's, AAHomecare reports. Twelve states say they will not be changing their fee schedules at this time, and 10 states say they are still analyzing data with AAHomecare and/or CMS. “It's gratifying to work alongside so many dedicated individuals across the country to encourage state Medicaid officials to take a careful look at their options for complying...