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Tag: Medi-Cal


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,...

Bob Achermann, CAMPS, Coronavirus Outbreak, Medi-Cal

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Also Noted

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...

Home Medical Equipment, Medi-Cal

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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...

21st Century Cures Act, CAMPS, Home Medical Equipment, Medi-Cal

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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...

competitive bidding, Medi-Cal, OIG

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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...

durable medical equipment, Home Medical Equipment, Home Medical Equipment, Medi-Cal, Medi-Cal

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On the Editor's Desk

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...

cap, Medi-Cal, Medi-Cal, On The Editor's Desk

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On the Editor's Desk

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 more details...

manual wheelchairs, Medi-Cal, Medi-Cal, On The Editor's Desk

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