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Tag: Medicaid


Also Noted

State update: Carelon transition delayed 

July 1, 2024HME News Staff

WASHINGTON – Carelon Medical Benefits Management will not review Medicaid prior authorization requests for DMEPOS in Maryland (Wellpoint), Missouri (Healthy Blue) and Wisconsin (Anthem) on July 1 as planned, AAHomecare reports. The transition has been postponed until further notice, according to the association. “Suppliers in Maryland, Missouri and Wisconsin should continue to follow the current process when requesting authorizations for DMEPOS services under Medicaid,” AAHomecare...

Carelon, Medicaid, Prior Authorization


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Laura Williard

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Georgia: Providers ‘celebrate’ new contracts

June 12, 2024Theresa Flaherty

ATLANTA – Providers in Georgia, at press time, were waiting for the state Medicaid program to announce which case management organizations (CMOs) will receive contracts that include a new rate floor for DME.  In late 2023, Medicaid officials agreed to set the rate floor for DME at 100% of Medicaid fee-for-service rates and included the provision in its RFPs.  “(From providers in Georgia), I’ve heard of contracts that ranged from 60% to 80% of the current rate, so...

Georgia, Medicaid, Medicaid Managed Care


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Aeroflow Health supports new moms in VA 

May 20, 2024HME News Staff

ASHEVILLE, N.C. – Aeroflow Health is now serving the Virginia Medicaid population with lactation consultations. The company’s partnership with the state Medicaid program and its managed care organizations will connect new mothers to a network of lactation consultants and other maternal health services at little to no cost for them. “Aeroflow’s mission is to improve postpartum health outcomes for new mothers,” said Nicole Peluso, IBCLC, CD, CAHPE, Manager of Lactation...

Aeroflow Health, Breast Pumps, Medicaid, Women's Health


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KFF updates Medicaid enrollment tracker 

April 29, 2024HME News Staff

WASHINGTON – At least 20.3 million Medicaid enrollees have been disenrolled as of April 18, 2024, based on the most current data from all 50 states and the District of Columbia, the Kaiser Family Foundation has reported. Overall, 31% of people with a completed renewal were disenrolled in reporting states, while 69%, or 44.4 million enrollees, had their coverage renewed (one reporting state does not include data on renewed enrollees), KFF reports. Other findings from the data, according to KFF:...

disenrollment, Medicaid


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In brief: Cyberattack update, PBM reform, Medicaid hearing

April 26, 2024HME News Staff

MINNEAPOLIS – Change Healthcare says it has made “strong progress” restoring services impacted by a cyberattack in February.  In the April 22 update, Change Healthcare said that medical claims across the U.S. health system are moving at near-normal levels, as systems come back online or providers switch to other methods of submission. The company said it realizes there are a small number of providers who continue to be adversely impacted and it is working with them to find...

Change Healthcare, Cyberattack, Medicaid, PBM reform, Sunknowledge


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Reps. Rodgers, Guthrie put Medicaid under spotlight

April 25, 2024HME News Staff

WASHINGTON – House Energy and Commerce Committee Chair Cathy McMorris Rodgers, R-Wash., and Subcommittee on Health Chair Brett Guthrie, R-Ky., will hold a legislative hearing on April 30 to discuss legislative proposals that will strengthen the Medicaid program for individuals most in need. “Medicaid is indispensable to millions of Americans, particularly those with disabilities who rely on long-term services and supports,” they said in an announcement. “It’s critical...

Medicaid


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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

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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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