Tag: Medi-Cal
CHME: ‘We’re trying to be a little bit different’
April 25, 2025Theresa Flaherty, Managing Editor
FOSTER CITY, Calif. – California Home Medical Equipment’s dual role as a DME provider and now a pharmacy well positions the company to meet a new contract with Medi-Cal, the state’s Medicaid program.
“We were supplying enteral nutrition and blood glucose testing supplies to patients and those things got switched over to a pharmacy benefit within Medi-Cal, so a lot of people were kind of lost on where to go for that that type of thing,” said Diane Tackaberry,...
Industry pushes through carve out for complex rehab
February 9, 2023HME News Staff
SACRAMENTO, Calif. – NCART and the California Association of Medical Product Suppliers have scored several wins in California around a 10% rate reduction for Medi-Cal for CRT that was eliminated in the 2021-22 Budget Act and was effective Jan. 1, 2022. Though the California Department of Healthcare Services submitted the State Plan Amendment to make the change, it had still not been implemented or had any retroactive adjustments on claims paid since Jan. 1, 2022. DHCS has said a 10% cut for...
CAMPS seeks input on managed care transition
April 12, 2022HME News Staff
SACRAMENTO, Calif. – The California Association of Medical Product Suppliers (CAMPS) and the University of California, San Francisco, have launched a survey to collect provider experiences on the state’s transition to a Medi-Cal Managed Care Plan for California Children’s Services (CCS). Anonymous results from the survey, which should only take three to five minutes to complete, will be shared with the California Department of Health Care Services (DHCS). In 2018, DHCS instituted...
Medi-Cal to temporarily boost reimbursement rates
February 26, 2021Theresa Flaherty, Managing Editor
SACRAMENTO, Calif. – California’s Department of Health Care Services has reversed plans to reduce reimbursement for oxygen concentrators 40% and will instead increase rates until the end of the public health emergency.
DHCS has submitted a waiver to CMS to increase the reimbursement rate for respiratory equipment from 80% to 100% of Medicare rural rates and eliminate a 10% clawback. Those rates will be retroactive to March 2020,...
Medi-Cal drops drastic rate cuts
November 14, 2019HME News Staff
SACRAMENTO, Calif. - Medicaid officials in California have agreed to implement a fee schedule for DME based on 80% of Medicare's rural rates, VGM reports. That's an improvement from the state's initial plan to implement a fee schedule based on 80% of non-rural rates, a move that would have amounted to cuts of up to 60%. Under the initial plan, an oxygen concentrator (E1390), for example, would have been reimbursed at $55.19; now, it will now be reimbursed at $107.76. The California Association of...
Providers feel burned in California
September 6, 2019Theresa Flaherty, Managing Editor
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...
Bid program would save Medi-Cal millions, OIG says
April 3, 2014HME News Staff
WASHINGTON - Medi-Cal, California's Medicaid program, could have saved $3.9 million on standard power wheelchairs, oxygen systems and oxygen concentrators in 2011 by using a competitive bidding program, the Office of Inspector General (OIG) has found.In its report, the OIG recommended Medi-Cal establish a bidding program like Medicare's, or revise its reimbursement methodology so pricing is more in line with bid prices.Though it disagreed with the OIG's estimated savings, Medi-Cal agrees it should...
Medi-Cal squeezes providers
October 30, 2011HME News Staff
SACRAMENTO, Calif. - Medi-Cal, California's Medicaid program, is less and less of a viable business for providers, they say.
In June, Gov. Jerry Brown signed a state budget that includes an across-the-board cut of 10% to all Medi-Cal providers, including HME providers, physicians and hospitals.
The cut was slated to go into effect July 1, but CMS needs to approve it first. State officials estimate the cut would save $623 million.
"A big provider group met with (CMS Acting Administrator) Donald...
Another potential Medicaid nightmare
May 24, 2010Liz Beaulieu, Editor
Gov. Arnold Schwarzenegger this month issued a revised state budget for 2010-11 that proposes capping spending for DME, even power wheelchairs, to about $1,800 per Medi-Cal recipient per year.
“Part of it is, they haven't been successful in cutting reimbursement rates, so they're getting desperate,” said Bob Achermann, executive director of the California Association of Medical Product Suppliers (CAMPS). “The other part of it is, the governor is telling the legislature, 'This is...
Dodged a bullet
August 27, 2009Liz Beaulieu, Editor
It looks like rehab providers in California dodged a bullet. AAHomecare reported this week that the state's Medicaid program, Medi-Cal, no longer plans to contract out manual wheelchairs.
AAHomecare stated that the state met with manufacturers, providers and advocate groups in May. One of those providers: ATG Rehab. On its Web site, ATG Rehab states:
The event was a tremendous success and Medi-Cal took away a better understanding what we do each and every day serving our consumers.
For...