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Tag: Medicaid


CMS announces flexibilities for Medicaid 

March 18, 2024HME News Staff

WASHINGTON – CMS has announced additional flexibilities to help state Medicaid programs provide needed relief to providers and protect access to health coverage after the cyberattack at Change Healthcare.  CMS is encouraging states to submit Medicaid state plan amendments (SPAs) for authority to make certain interim payments for services providers have rendered but for which the provider cannot submit claims. The agency has now released guidance on related flexibilities, including the...

Change Healthcare, Cyberattack, flexibilities, Medicaid

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Iowa Medicaid starts paying for Firesafe Cannula Valve 

December 11, 2023HME News Staff

CHICAGO – Iowa Medicaid began covering the Firesafe Cannula Valve under HCPCS code E0700 on Nov. 1, making it eligible for reimbursement, Sunset Healthcare Solutions has announced. The Firesafe Cannula Valve is a thermal fuse that cuts the flow of oxygen in the event that a patient’s downstream oxygen tubing is ignited. “Prevention of home oxygen therapy related fires, and education around how they can be significantly reduced, has been an initiative of Sunset’s for years,”...

Firesafe Cannula Valve, Home Oxygen Therapy, Iowa, Medicaid

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NC expands Medicaid program 

December 5, 2023HME News Staff

RALEIGH, N.C. – About 600,000 people living in North Carolina aged 19 to 64 are now eligible for health coverage through the Affordable Care Act’s Medicaid expansion. North Carolina is the fourth state to expand Medicaid coverage during the Biden-Harris administration, joining Missouri, Oklahoma and South Dakota. “Medicaid Expansion is the working families bill of the decade for North Carolina, and its impact on peoples' health, combating the opioid crisis, saving rural hospitals...

Expansion, Medicaid, North Carolina

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Beth Bowen


Providers in NC to receive rate increase

November 1, 2023HME News Staff

RALEIGH, N.C. – HME providers in North Carolina will receive a rate increase for 13 products that equates to about $3.2 million more for their bottom lines over an eight-month period.  Members of ACMESA’s Medicaid and legislative committees and AAHomecare’s payer relations team have lobbied for the increase for two years, following the state’s decision to discontinue a 5% rate increase related to the COVID-19 pandemic.  “ACMESA is thankful for the...

AAHomecare, ACMESA, Medicaid, North Carolina

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Andrea Stark


Medicaid disenrollment highlights need for increased automation

August 11, 2023Liz Beaulieu, Editor

WASHINGTON – HME providers might feel like they’ve been “whipsawed” by the current Medicaid disenrollment, but there are tools and processes they can implement to continue business as usual, say industry stakeholders.  As of Aug. 1, 2023, states have disenrolled at least 3.8 million Medicaid recipients based on the most current data from 41 states and the District of Columbia, according to Kaiser Family Foundation (KFF).  “There’s a lot of whipsawing...

Andrea Stark, Home Medical Equipment (HME), Medicaid

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OIG: More oversight needed of Medicaid managed care

July 20, 2023HME News Staff

WASHINGTON – Some people enrolled in Medicaid managed care may not be receiving all of their medically necessary health care services, according to a new study from the Office of Inspector General.  There are three key factors causing concern, the OIG says: the high number and rates of denied prior authorization requests; the limited oversight of prior authorization denials in most states; and the limited access to external medical reviews.  What the OIG found  Overall,...

Managed Care, Medicaid, Office of Inspector General (OIG)

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Massachusetts Medicaid pays for wheelchair repairs 

July 5, 2023HME News Staff

BOSTON – The Medicaid program in Massachusetts has added new procedure codes and corresponding rates for shipping fees and wheelchair repair evaluation, according to NCART. The new codes and rates went into effect July 1. They are: Code A9901, $3, DME delivery, set up and/or dispensing service component of another HCPCS code.  Modifier U7: Used in conjunction with K0739 for direct service components when an in-person evaluation is performed for the repair of a mobility system RE-1...

Medicaid, NCART, Wheelchair

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Mickae Lee


NCART to Medicaid: ‘We can’t continue down this road’

June 30, 2023Liz Beaulieu, Editor

WASHINGTON – NCART has officially put state Medicaid programs on notice that they should be following Medicare’s lead in implementing a reimbursement increase for complex rehab products and services.  NCART in June sent letters to state Medicaid programs, asking them to increase their reimbursement and to work with the organization and other stakeholders to develop policies that best serve people with disabilities.  “We’re putting a lot of focus on reimbursement...

Complex Rehab Technology (CRT), Medicaid, NCART, Wayne Grau

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Wayne Grau

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NCART calls for Medicaid reimbursement increase 

June 26, 2023HME News Staff

WASHINGTON – NCART has sent letters to state Medicaid programs asking them to increase reimbursement rates for complex rehab technology products and services. The organization points out that CMS implemented a reimbursement increase for Medicare in January to address inflation. "CRT plays an irreplaceable role in maximizing independence, quality of life and community access for individuals with significant disabilities," says Wayne Grau, executive director of NCART. "We are calling on payers...

Medicaid, NCART, Reimbursement

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HHS announces Medicaid flexibilities as millions face dis-enrollment

June 13, 2023HME News Staff

WASHINGTON - The Department of Health and Human Services (HHS) has announced new flexibilities to help keep Americans covered as states resume Medicaid and Children’s Health Insurance Program (CHIP) renewals.   Continuous Medicaid enrollment established under the Families First Coronavirus Response Act (FFCRA) ended on March 31, 2023, and millions of Medicaid beneficiaries stand to lose coverage in the coming months.  The new flexibilities were announced in a letter Secretary...


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