Recently UTMED became aware of Medicaid’s recent interpretation regarding policy on prior authorization and reimbursement for wheelchairs. These interpretations of the policy were causing concern throughout the industry, particularly for patients and access to wheelchairs. We met multiple times with members of the industry and the association to address the issue and how we could address this with Medicaid. We met last month with medicaid and voiced our concerns.
Last week we were told that Medicaid would revert to their previous interpretation of the policy. Today we received the following letter outlining that Medicaid is reinstating their previous interpretation of the policy and that they would continue to look at the policy with the industry’s feedback and participation.
Read MoreATLANTA – Ask Medtrade Education Director Jeff Baird how he and his colleagues develop the most relevant education for HME providers at this week’s conference and expo, and he’ll tell you it comes down to timing.
“The Medtrade Education Advisory Board spends substantial time debating what is relevant to HME providers today and into the future,” he said. “The EAB recognizes that the HME industry today is different from what it was a few years ago, and in a few years it will be different from what it is today. We look at proposals that have been submitted and select those that we believe are most relevant and even then we may ask the speaker to modify the proposed program.”
Read MoreATLANTA – Do you know what your HME company’s key performance indicators are? At Medtrade, during the session “Key Performance Indicators for your DME Revenue Cycle" on Tuesday, Joey Graham, general manager of Prochant, will explore how to identify, measure and impact KPIs for HME providers.
HME News: What percentage of HME providers keeps track of KPIs?
Joey Graham: It’s super scattered, both in terms of the level of implementation of KPIs and the way providers calculate them. There’s no standardized platform.
HME: Make the case for why KPIs should be a big part of any provider’s business.
Graham: Because otherwise, how do you know what you’re doing, whether your company’s performance is acceptable or unacceptable? It’s like driving a bus forward, but you can’t turn around and you have no idea where you’ve been.
Read MoreAgency’s website will increase transparency into Accrediting Organization performance, and CMS will streamline and strengthen the validation of Accrediting Organization surveys
Today, the Centers for Medicare & Medicaid Services (CMS) took action to improve quality and safety in healthcare facilities and empower patients with information to make decisions about where to receive care.
“Today we are taking action to improve our oversight of Accrediting Organizations, including by increasing transparency for patients on the organizations’ performance,” said CMS Administrator Seema Verma. “The public trusts CMS to ensure the quality and safety of patient care, and we take this responsibility very seriously. Today's changes will bolster the processes for overseeing how effective Accrediting Organizations, who work on CMS’ behalf, are in evaluating healthcare facilities.”
Read MoreIf your patients accidentally threw away their new Medicare card, ask them to call 1-800-MEDICARE and request a replacement. Your patients can also sign into MyMedicare.gov to print an official card. They must create an account if they do not already have one.
Read MoreStrong 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.
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.
Read MoreIt 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).
Read MoreRecently 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: