Tag: Minnesota
HHS, CMS pause $1B in federal matching funds to Medicaid programs in two states
July 22, 2026HME News Staff
WASHINGTON – The Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) have deferred more than $1 billion in federal Medicaid payments to California and Minnesota while the states provide additional documentation supporting certain claims. CMS says it is withholding approximately $867.5 million from California and $199 million from Minnesota following focused financial reviews that identified claims requiring further scrutiny. “CMS is done...
Minnesota Senate bill seeks power standing coverage
February 12, 2025HME News Staff
MINNEAPOLIS, Minn. - A bill was introduced in the Minnesota Senate that would require health insurance plans, medical assistance and MinnesotaCare to cover power standing systems for wheelchairs. The bill, SF 974, mandates that all health plans provide this coverage without imposing additional cost-sharing requirements, review limitations or quantity restrictions beyond one system every five years. Health plans must report their costs related to this new benefit, and the commissioner will evaluate...
Minnesota: Budget includes DME cuts, but it lacks Senate support
February 3, 2021HME News Staff
MINNEAPOLIS – Minnesota Gov. Tim Walz’s 2022-2023 budget recommendations include cuts to DME, according to a bulletin from MAMES. Specifically, the budget proposes changing the Medical Assistance reimbursement formula for durable medical equipment that is also covered by Medicare but is not currently subject to the upper payment limit to the equivalent of the Medicare rate. The state’s Department of Human Services estimates the...
State news: Minnesota pauses recoupments
December 29, 2020HME News Staff
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...
State news: Hazard pay in Pennsylvania, growing threat in Minnesota
July 29, 2020HME News Staff
HARRISBURG, Pa. - The Pennsylvania Association of Medical Suppliers (PAMS) has helped to secure COVID-19 hazard pay for HME providers as part of the state's grant program for frontline workers, AAHomecare reports. The Department of Commerce and Economic Development added HME providers to the definition of qualified recipients after a letter to Gov. Tom Wolf, and numerous emails between Mindy Eberhart, executive director of PAMS, and the department. “We are pleased that the Pennsylvania DCED...
State news: Minnesota, Kansas
February 26, 2019HME News Staff
Minnesota Gov. Tim Walz has released budget recommendations for 2020 and 2021 that include reimbursement cuts for DME, MAMES reports. Walz proposes changing “the medical assistance reimbursement formula for durable medical equipment that is also covered by Medicare to pay equivalent to the Medicare rate�This would reduce payment for DME starting in FY 2019 and reduce the value of recoveries in the forecast starting in FY 2021.” Walz also proposes simplifying reimbursement for products...
Minnesota Medicaid proposes 'claw back'
February 22, 2019Liz Beaulieu, Editor
SAINT PAUL, Minn. - A meeting in early February between HME stakeholders and Minnesota Medicaid officials on how to comply with a provision in the 21st Century Cures Act that requires Medicaid reimbursement not to exceed Medicare allowables ended in a stalemate.
The state had initially sought input from HME stakeholders on its plan to implement a “claw back” for payments stretching back to Jan. 1, 2018.
“It was determined that we would no longer discuss Cures for we weren't...
State news: Illinois targets MCOs, Minnesota gets approval from judge
September 14, 2018Theresa Flaherty
SPRINGFIELD, Ill. - Proponents say a bill in the Illinois House of Representatives that would address reimbursement cuts for home medical equipment and supplies is critical as more and more payers offer below-Medicaid rates.This year, IlliniCare Health, a Medicaid MCO, announced rate cuts ranging from 10% to 50%. House Bill 5930 would prohibit MCOs from paying providers less than 10% below Medicaid “fee for service” rates.“IlliniCare was the first one, but there's been quite a bit...
Minnesota Medicaid could have saved millions with bid pricing, OIG says
February 11, 2014HME News Staff
ST. PAUL, Minn. - The Minnesota Medicaid program could have saved an estimated $2.27 million in one year by establishing a DME competitive bidding program similar to Medicare's, according to a new report from the Office of Inspector General (OIG). The OIG determined that average Medicare payment rates obtained through competitive bids for 42 selected DME items were significantly lower than Minnesota's average Medicaid payment rates. The state agreed that it could achieve lower rates of payment...