Skip to Content

Tag: Reimbursement


Noel Neil

Smart Talk

Reimbursement: Understand new flexibility

March 13, 2024Noel Neil

Q. Can I apply the same new guidance for PAP masks to other accessories?  A. In February 2024, the DME MACs published a Dear Physician Letter (DPL) clarifying Medicare’s stance of masks for PAP and RAD devices. The DPL specifically addressed the PAP and RAD device masks, but does the same flexibility apply to other accessories such as tubing, cushions or pillows?   The letter indicates:  In order to promote patient adherence to PAP or RAD therapy, the treating practitioner...

ACU-Serve, Noel Neil, Reimbursement


Read Full Articlered right arrow icon

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


Read Full Articlered right arrow icon

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


Read Full Articlered right arrow icon

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


Read Full Articlered right arrow icon

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


Read Full Articlered right arrow icon

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 Group


Read Full Articlered right arrow icon

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 Group


Read Full Articlered right arrow icon

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


Read Full Articlered right arrow icon

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


Read Full Articlered right arrow icon

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


Read Full Articlered right arrow icon