Tag: Medicaid

EAST AMHERST, N.Y. – NCART has come right out of the gate in 2022 to work on Medicaid issues, including protecting reimbursement for complex rehab.  The association, through its CRT Payer Relations Committee, is working on various issues in at least 10 different states, including California and Illinois, where legislation has been introduced to recognize and protect the specialized nature of complex rehab.  “That issue is going to continue to be a part of our priority...

RALEIGH, N.C. – North Carolina Gov. Roy Cooper on June 29 signed S594, a bill that creates a rate floor for durable medical equipment, ACMESA and AAHomecare report.  Per the legislation, reimbursement for DME will be set at 100% of the lesser of the supplier’s usual and customary rate or the maximum allowable Medicaid fee-for-service rates for DME and supplies, orthotics and prosthetics.  The legislation, which went into effect July 1, protects rate floor provisions for...

WASHINGTON – CMS has named Daniel Tsai as Deputy Administrator and Director of Center for Medicaid and CHIP Services, effective July 6. Tsai will lead the Center’s efforts to address disparities in health equity and serving the needs of the record 80 million children, pregnant people, parents, seniors, and individuals with disabilities. “As someone who has successfully led a state Medicaid program to focus on value-based care for its recipients, Dan brings invaluable experience...

WASHINGTON – CMS has announced a 90-day suspension of scheduled Medicare cuts to accessories for complex rehab manual wheelchairs, NCART reports.  That extends an 18-month suspension that would have expired on July 1 to Oct. 1.  “They will use this time for further analysis and, hopefully, a permanent suspension,” Don Clayback, executive director of NCART, tweeted today. “Thank you advocates, Congress and CMS.”  On Monday, a letter led...

WASHINGTON – A record more than 80 million individuals now have health coverage through Medicaid and the Children’s Health Insurance Program (CHIP), according to a new Enrollment Trends Snapshot Report that CMS released this week.  Nearly 9.9 million individuals, a 13.9% increase, enrolled in coverage between February 2020, the month before the public health emergency was declared, and January 2021, according to the report, which is released monthly.  “This report...

AAHomecare has worked with TexMEP and other stakeholders to get three bills introduced in the state legislature on rate stability and patient access to quality HME. HB 3679 would require Medicaid managed care organizations to reimburse providers at no less than 95% of the state’s published Medicaid DME fee schedule. HB 3678 would update the insurance code to support Medicaid continuity of care and patient choice language, and ensure adequate reimbursement. HB 3677 would amend...

COLUMBIA, S.C. – HME providers are fighting large managed care organizations that are increasingly pushing into more states and offering reduced reimbursement rates, say industry stakeholders.  The straw that’s breaking the camel’s back: The COVID-19 pandemic pushing the cost of doing business even higher, says Craig Douglas, vice president of payer and member relations for VGM.  “Acquisition...

ALBANY, N.Y. – AAHomecare is calling on providers in New York to help build support for two new bills in the state legislature that would require Medicaid managed care organizations to reimburse for DME and complex rehab at no less than 100% of the published Medicaid fee schedule for the same services and supplies. A.5368 was introduced in the State Assembly on Feb. 16 and S.5118 was introduced in the State Senate on Feb. 24. “This legislation is critically needed to ensure...

NASHVILLE, Tenn. – CMS has approved Tennessee’s request for a block grant waiver for its state Medicaid program, TennCare, AAHomecare reports. The new program will allow TennCare to administer Medicaid with less oversight from the federal government, increasing its flexibility. The new block grant waiver – known as TennCare III – came after the General Assembly passed a law in 2019 directing Gov. Bill Lee’s administration to negotiate...

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...