Tag: Reimbursement
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...
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...
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...
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...
In brief: Seat elevation systems are a go, Florida providers get rate increase
May 17, 2023HME News Staff
WASHINGTON – CMS late on Tuesday posted a final benefit category determination and national coverage decision for seat elevation systems as an accessory to power wheelchairs.
Effective immediately, seat elevation for Medicare-covered power wheelchairs is now considered a clinically meaningful benefit to people with Medicare who perform transfers from power wheelchairs or use the chair for mobility related activities of daily living, such as dressing, grooming, toiletry, feeding and...
Stakeholders: ‘Timing couldn’t be better’
April 28, 2023Theresa Flaherty, Managing Editor
WASHINGTON – Industry stakeholders head to the Hill next week armed with new reimbursement relief legislation in the Senate, and they’re angling to have legislation in the House of Representatives, too.
“Our goal was to get (the bill) accomplished in the first four months of the new Senate, so the timing couldn’t be better,” said Tom Ryan, president and CEO of AAHomecare.
AAHomecare is hosting 50 industry stakeholders from around the country in Washington,...
Senate bill introduced to provide reimbursement relief
April 27, 2023HME News Staff
WASHINGTON – Sens. John Thune, R-S.D., and Debbie Stabenow, D-Mich., have introduced S.1294, a bill that would extend the 75/25 blended Medicare reimbursement rate for suppliers in non-rural, non-competitive bidding areas through the end of 2024.
“This bill would provide an additional measure of relief and stability for non-rural, non-CBA suppliers and also have positive impacts on rates from other payers who are influenced by Medicare rates," said Tom Ryan, AAHomecare president...
CMS announces MA payments for 2024
April 3, 2023HME News Staff
WASHINGTON – Medicare Advantage plan payments will increase 3.32% from 2023 to 2024, representing about $13.8 billion.
Previously, in an advance notice, CMS had proposed a 1.03% increase.
“Medicare should be providing equitable, high-quality affordable care that will be available for our children and grandchildren,” said CMS Administrator Chiquita Brooks-LaSure. “Paying Medicare Advantage plans more accurately for the care they provide is how we ensure that...
Stakeholders push closer to new legislation
March 31, 2023Theresa Flaherty, Managing Editor
WASHINGTON – Fresh off its latest round of Hill visits, AAHomecare is confident it will have a bill in hand to address reimbursement in time for a legislative fly-in scheduled for May, says President and CEO Tom Ryan.
The industry is again seeking to implement a 90/10 blended reimbursement rate in former competitive bidding areas and to make permanent a 75/25 blended reimbursement rate for non-bid/non-rural areas that was extended as part of a year-end spending package in December.
“What...
Off to the races: ‘We need to do more work in the Senate’
February 3, 2023Theresa Flaherty, Managing Editor
WASHINGTON – With a new Congress in session, AAHomecare has begun the work of relationship building as the HME industry seeks to advance reimbursement relief and other priorities.
Despite a delay in getting the 118th Congress seated – on Jan. 7, instead of Jan. 3 – Jay Witter was able to connect with about 20 offices in early January, speaking directly with lawmakers that have either helped the industry already or could be helpful in the future, he said during a recent...