Tag: North Carolina

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...

CHARLOTTE, N.C. – North Carolina Medicaid has agreed to extend a 5% rate increase for home medical equipment for two months, until Nov. 30, according to AAHomecare. Medicaid officials have also agreed to meet with ACMESA to discuss extending the relief beyond Nov. 30.  “North Carolina providers are elated that NC Medicaid elected to extend the 5% Covid relief,” said Craig Rae, ACMESA president. “In light of the continued cost increases we’re facing, this helps protect...

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...

RALEIGH, N.C. - North Carolina Gov. Roy Cooper on July 2 signed Bill 808, including a provision creating a rate floor for durable medical equipment.The bill, a year in the making by groups like ACMESA and AAHomecare, prohibits managed care organizations from setting rates below the state's Medicaid fee-for-service rates for DME.“ACMESA's strong relationship with AAHomecare enabled us to learn from the problems experienced in other states as they rolled out their MCO programs,” said Craig...

RALEIGH, N.C. - HME providers here got a reprieve in November when North Carolina suspended its transition to Medicaid managed care after Gov. Roy Cooper vetoed a $502 million bill to fund it. The program was slated to begin Feb. 1, with many providers already enrolled with one of the five managed care plans. “At this point, they are not cancelling the contracts, but they are suspending related activities,” said David Chandler, director of payer relations for AAHomecare. “They...

RALEIGH, N.C. - The North Carolina General Assembly has passed a bill that exempts medically prescribed diapers and incontinence products covered under the Medicaid program from the state sales tax starting Oct. 1, according to AAHomecare. “This is a great win for the industry that was accomplished by the collaborative work of our lobbyist working with AAHomecare, ACMESA and other provider lobbyists,” said Gayle Devins, CEO of ActivStyle. The bill, S. 523, now moves to Gov. Roy Cooper...

Fifteen members of the Oklahoma Medical Equipment Providers Association (OMEPA), other providers from the state and VGM's Jay Kopriva joined forces at the state capitol in Oklahoma City on Feb. 5 to educate and gather support from their state representatives for H.B. 1407, a bill that would exempt HME from sales tax. Currently, Oklahoma is one of only a few states that charges sales tax on HME and supplies. “We received overwhelming support for the bill,” Kopriva said in a VGM bulletin....

ASHEVILLE, N.C. - Aeroflow Healthcare will be able to provide even more support for its patients now that North Carolina Medicaid reimburses for home non-invasive ventilators. “For years, N.C. Medicaid patients with chronic respiratory failure, hypoventilation, neuromuscular disorders, and other diagnoses were unable to receive non-invasive ventilation (NIV) therapy, because Medicaid would not cover it,” said Rob Hunter, Aeroflow sales director. “Now that NC Medicaid will cover...

RALEIGH, N.C. - Blue Cross Blue Shield Of North Carolina announced Dec. 13 that it will not update current fee schedules with the 2017 rates recently released by CMS. Because the decision is in conflict with its current policy and current contracts with DME providers, a contractual amendment will be mailed in early to mid-January, with an effective date of Jan. 1, 2017. It will continue to use the January 2016 rates until further notice. "Our association has worked hard over the years maintaining...

RALEIGH, N.C. - More than a year after its implementation, HME providers here are still grappling with problems created by the state's new Medicaid billing system. “We've asked them to let us be involved in testing and fixing solutions,” said Laura Williard, senior director of reimbursement and contracting for High Point-based Advanced Home Care. “It's not something they are open to. We have been told we will slow down the process, but we don't want it fixed quickly;...