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Tag: Reimbursement


Tom Ryan

News

Lack of reimbursement relief starts to set in

February 9, 2024Theresa Flaherty, Managing Editor

WASHINGTON – With Medicare reimbursement decreases in non-rural areas now in effect, including 32% for oxygen and 37% for manual wheelchairs, HME providers are faced with making potentially difficult business decisions if relief doesn’t come their way soon, say industry stakeholders.  Congress in January passed a stripped down, short-term government funding measure without including any significant health care extenders, including a provision to extend a 75/25 blended rate in...

AAHomecare, home medical equipment, Reimbursement


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Noel Neil

Smart Talk

Reimbursement: Document qualifying test result 

February 7, 2024Noel Neil

Q. What do I need to document in the medical record to meet current oxygen policy requirements?   A. The current oxygen policy requires the practitioner to order and evaluate the results of a qualifying blood gas study performed at the time of need. I believe this requirement stems from the national coverage determination (NCD) but Medicare confirmed that the practitioner does not necessarily have to document that “I personally reviewed the qualify test result.”   However,...

ACU-Serve, Noel Neil, Reimbursement


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Also Noted

Reps seek to eliminate physician cut 

December 11, 2023HME News Staff

WASHINGTON – A group in the House of Representatives led by Rep. Greg Murphy, R-N.C., Danny Davis, D-Ill., Brad Wenstrup, R-Ohio, Jimmy Panetta, D-Calif., Larry Bucshon, R-Ind., and Michael Burgess, R-Texas, has introduced a bill that would eliminate the 3.37% cuts to Medicare payments for physicians scheduled to go into effect Jan 1, 2024. “As of today, patients and physicians have a clear-eyed view on how to protect Medicare from injurious cuts,” said Jesse Ehrenfeld, M.D., M.P.H,...

Medicare, physicians, Reimbursement


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News

In brief: SoClean field correction, HCD CEO, reimbursement relief efforts 

November 29, 2023HME News Staff

PETERBOROUGH, N.H. – SoClean on Nov. 16 issued an urgent medical device field correction that provides clarifications to the user manuals for its SoClean2 and SoClean 3 and notifies users of the availability of a hose and mask adapter for the maintenance systems.  SoClean is revising its labeling to incorporate additional warnings and contraindications, as well as proper and consistent device setup instructions, including use of a hose and mask adapter to reduce potential risks associated...

Home Care Delivered, Reimbursement, SoClean


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News

In brief: Lobbying for reimbursement relief heats up & React Health integrates with sovaSage, EnsoData 

November 1, 2023HME News Staff

WATERLOO, Iowa – VGM Government Relations has a goal of scheduling 55 visits with legislators or their staffers in 55 days in a final push to get H.R. 5555 and S. 1294 passed in Congress.  “We are in the bell lap of the legislative session, and your voice is needed now to get us across the finish line,” said Mike Isaacson, senior vice president of government relations and regulatory affairs for VGM & Associates. “There is so much happening on Capitol Hill that the...

EnsoData, React Health, Reimbursement, sovaSage, VGM


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Mike Isaacson

News

VGM launches ‘Champions of Change: 55 in 55’ 

October 30, 2023HME News Staff

WATERLOO, Iowa – VGM Government Relations has a goal of scheduling 55 visits with legislators or their staffers in 55 days in a final push to get H.R. 5555 and S. 1294 passed in Congress.  “We are in the bell lap of the legislative session, and your voice is needed now to get us across the finish line,” said Mike Isaacson, senior vice president of government relations and regulatory affairs for VGM & Associates. “There is so much happening on Capitol Hill that the...

Champions of Change, Reimbursement, VGM


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Jay Witter

News

Stakeholders hit the ground running with new bill 

September 22, 2023Theresa Flaherty, Managing Editor

WASHINGTON – The HME industry needs to be “prepared for anything,” stakeholders say, to get reimbursement relief in place for 2024.  Stakeholders converged virtually on Capitol Hill on Sept. 20 as part of AAHomecare’s Washington Legislative Conference to push the DMEPOS Relief Act of 2023 (H.R. 5555), a bill that would provide a 90/10 blended Medicare reimbursement rate for most home medical equipment products in competitive bidding areas for all of 2024 and extend...

AAHomecare, Reimbursement, Relief, Washington Legislative Conference


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Wayne Grau

Also Noted

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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News

Regulatory update: Ventilator access, bid relief support 

June 15, 2023HME News Staff

ARLINGTON, Va. – AAHomecare and the ALS Association asked CMS to promptly issue a memorandum clarifying medical policy and coverage of non-invasive ventilators (NIVs) and take steps to expedite authorizations for people living with ALS.  They shared their concerns about reports of denials as high as 86% and 64% for two major MA plans, with rates in the low teens for other MA plans. They report issues for both new setups and continued authorizations.  “The ALS Association...

AAHomecare, Amyotrophic Lateral Sclerosis (ALS), Competitive Bidding, Non-invasive ventilator, Reimbursement


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Jay Witter

News

Competitive bidding: Stakeholders on watch for further developments  

June 2, 2023Theresa Flaherty, Managing Editor

WASHINGTON – Industry stakeholders will keep an eye on CMS as it takes next steps toward a new round of competitive bidding and will act to preserve current guardrails for the program, they say.   CMS on May 25 announced a temporary gap period in the program starting Jan. 1, 2024. Contracts for off-the-shelf back and knee braces for the current round, Round 2021, expire on Dec. 31, 2023.    “It takes 18 months or more to get the bid program up and running and...

AAHomecare, Competitive Bidding, Reimbursement


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