Congressional Sign-on Letter Supporting Additional Relief for ESRD/DMEPOS Rule Released
Federal Financial Participation (FFP) Available to States to Help Offset their Medicaid Spend
Strong Grassroots Effort Needed to Ask House Members to Join Letter
Rep. Cathy McMorris Rodgers (R-Wash.) has released a Congressional sign-on letter to leadership at CMS, HHS, and OMB asking for additional relief for the HME community in the proposed ESRD/DMEPOS Rule currently under consideration. We are asking HME providers and other stakeholders to ask their Representatives in the House to join the letter as soon as possible.
Correct Coding – Submitting Oxygen Claims with Modifiers KX, GA, GY, and GZ
At the end of 2017, and stemming from language contained within the 21st Century CURES Act, the Medicaid directors in every state received a letter from CMS which outlined the amount of Federal Financial Participation (FFP) that was available to states to help offset their Medicaid spend. The maximum amount of FFP available to states was limited to Medicare rates. In essence, if a state paid out more than Medicare rates, they would be “on the hook” financially for any overage above the Medicare fee schedule. This left many states scrambling to adjust their Medicaid fee schedules going forward, so that they wouldn’t be on that proverbial financial hook for payments made that were above and beyond the Medicare rates.
Sales Tax and Durable Medical Equipment - A Members Perspective
It has recently come to the attention of the DME MACs that there are instances whereby a supplier possesses information that a beneficiary does not meet Medicare “Reasonable and Necessary” requirements for oxygen as specified in the Oxygen and Oxygen Equipment Local Coverage Determination (LCD L33797).
Grassroots Advocates Needed
Recently Alpine Home Medical had a sales tax audit. This audit dispelled our prior understanding that items requiring a prescription from a third party payer are exempt from sales tax.
During our audit, the State auditor indicated that breast pumps were not exempt from sales tax. He sighted the definition of what qualifies as “Durable Medical Equipment” under Publication 53. This publication defines Durable Medical Equipment to meet five qualifiers:
Nomination of Alex Azar as Secretary of Health & Human Services
We want your help with an industry-wide initiative to establish a volunteer HME contact for each of the 535 federal legislative offices! As you well know, advocacy is a cornerstone of our Industry as we navigate through these transformative times. We need to build champions on Capitol Hill who will fight for the HME Industry and those we serve.
In partnership with AAHomecare’s State Leaders Council, we are working to assign a primary and secondary grassroots advocate to every legislator so that whenever there’s a Call to Action/Ask, we know that we’re hitting all of the offices.
Breaking: Senate Letter Outlines DME Access Concern; Contact Your Senators to Support! Small timeframe!
The U.S. Senate Committee on Health, Education, Labor & Pensions (HELP) held a hearing this morning in the 430 Dirksen Senate Office Building for the nomination of Alex Azar to serve as Secretary of Health & Human Services (HHS). If you missed the hearing you can still view it online at https://www.help.senate.gov/hearings/nomination-of-alex-azar-to-serve-as-secretary-of-health-and-human-services
AAHomecare Meets with CMS General Counsel
There is now a letter being circulated through the United States Senate that outlines the urgent reforms needed in the DMEPOS industry. Sens. John Thune (R-S.D.) and Heidi Heitkamp (D-N.D.), two of the most engaged senators on DMEPOS issues, saw the attention and support the House letter on DMEPOS reforms received and stepped up to lead the charge in the Senate.
The letter addresses the key issue that impacts a vast number of independent providers across the country, which is the high cost of providing care in non-competitively bid areas.
Spring 2017 President's Message
AAHomecare continues to press the case for longer-term relief for rural and non-bid area providers as well as for significant structural improvements to the Competitive Bidding Program with Federal regulators.
Last week, AAHomecare’s Tom Ryan and Jay Witter, along with Thomas Barker, an attorney recently engaged by the Association, and Cara Bachenheimer of Invacare, had a productive meeting with the CMS Office of ...
Registration is Now Open for the Washington Legislative Conference 2017
This message comes to you with hope that your 2017 is off to a strong start with a bright outlook for the rest of the year, both in your personal and professional lives. I am happy to report that the Utah Medical Equipment Dealers Association is moving full steam ahead with many positive changes in the works.
As of August 2016, the board has decided to partner with Association Solutions based in Midvale to improve the organization and functionality of UTMED. We have a new website where we hope to keep you updated with all topics and events relative to the DME industry.
Each year the HME community comes together in Washington, D.C. to advocate and strengthen relationships in Congress. It is a critical gathering, made stronger by greater numbers of participants demonstrating how important our relatively small share of the Medicare budget is to the entire healthcare continuum. While we made progress in 2016 convincing more members of Congress that current Medicare rates for DME aren’t sustainable and securing a measure of relief for rural providers, it is essential that we continue pressing our issues and concerns on Capitol Hill. Even if our most likely path to a longer-term fix on rural reimbursement, meaningful improvements for the next round of competitive bidding, and excluding CRT accessories from bidding-derived pricing is likely to run through federal agencies, Congressional interest and support is essential to the process.