Monday, April 24, 2017

Call for Action: Help Stop "Double Dip" Cuts for Stationary Oxygen by Reaching Out to Capitol Hill

Rural and non-bid area oxygen suppliers need relief from “double dip” cuts in the 2017 Medicare fee schedule for stationary oxygen, which result in rates for rural and other non-bid area suppliers that are lower than the competitive bidding rates for this product category in many CBAs.  These new rates stem from the application of a 2006 budget neutrality offset balancing increased utilization for oxygen generating portable equipment with lower reimbursement for stationary equipment.

AAHomecare has raised concerns about the issue in a letter to the outgoing CMS General Counsel and is now engaging new leadership at HHS and CMS on the issue.  We would like to reinforce these efforts by generating Congressional interest and support on the issue as well.

If these additional cuts are impacting your company’s bottom line and your ability to serve patients, please let your Senators and Representative know your concerns, and ask them to contact CMS on your behalf.  You can use these points as a guideline for your discussions with CMS:


  1. Medicare improperly reduced payments for E1390 concentrators by applying a regulation introduced in 2006 that only should be applied to unadjusted fee schedules called the budget neutrality offset. 
  2. CMS’ inappropriate application of the budget neutrality offset has resulted in rural and non-bid area rates being lower than CBA rates in many cases.
  3. The 2017 adjusted fee schedule payments for stationary oxygen equipment must be consistent with those based on regional average SPAs from CBAs.
  4. How these cuts affect your business and patients.

If you need assistance crafting your message or contact information for healthcare legislative assistants in House & Senate offices, please contact Gordon Barnes at gordonb@aahomecare.org. Please also see our comparison of the rural and non-bid area rates to selected bid area rates for more perspective.

Thursday, April 20, 2017

Share Your Expertise at Medtrade

AAHomecare members have a great deal of knowledge in sales and marketing, strategic planning, executive leadership, retail, business operations, competitive bidding and so much more. Have you considered sharing your expertise with others? Consider working with a colleague to submit a proposal to present at Medtrade. Priority for this year’s program is given to town hall/panel format presentations with two or more presenters. And sessions with a provider participating will be given top consideration in the proposal process! Presentations are 1 hour or 1.5 hours in length with time for Q&A.

The show will take place October 23-26, 2017 in Atlanta, Ga. This is a great opportunity to help build the knowledge of your peers and create a stronger HME business community. The proposal deadline is Thursday, April 27. You can submit online, or email Toni Ward, conference manager with questions at antoinette.ward@emeraldexpo.com.

#AAHWLC2017 

Thursday, March 9, 2017

Legislation Introduced for CRT Accessories Has Strong Bipartisan Support

Legislation to prevent the application of bidding-derived pricing for CRT accessories was introduced in the Senate and House last week.  The legislation is needed due to CMS' attempt to apply competitive bid program pricing to CRT accessories effective January 1, 2016.  Congress has twice passed legislation to delay this measure, most recently through provisions in the CURES bill that hold off bidding-derived rates until July 1, 2017.

The Senate bill, S. 486, introduced by lead sponsors Sens. Rob Portman (R-Ohio) and Bob Casey (D-Pa.), and its House companion, H.R. 1361, introduced by Reps. Lee Zeldin (R-N.Y.) and John Larson (D-Conn.) both show strong bipartisan support from initial co-sponsors.

“CRT providers need a permanent fix that will ensure that they can continue to support individuals with serious disabilities that depend on this specialized equipment,” said Tom Ryan, president and CEO of AAHomecare.  “If bidding-derived pricing is allowed to slash reimbursement rates, these companies simply can’t provide the level of clinical care associated with CRT products and accessories, including patient evaluation, as well as configuration, fitting, and adjustments for the equipment.”

“After two timely delays, rehab providers are finally at a critical juncture where the ill-conceived proposed cuts to 171 CRT accessory codes can be put to rest," said Georgie Blackburn, vice president of government relations and legislative affairs for BLACKBURN’S. “Plain and simple, MIPPA 2008 exempted CRT power chairs and accessories from the bid program."

“I’m thrilled to see that we have congressional leadership recognizing this, resulting in S.486 and H.R. 1361, and that we now have Secretary Tom Price leading HHS,” added Blackburn, who also serves as a member of AAHomecare’s Complex Rehab & Mobility Council (CRMC).  “I have never felt so optimistic that logic will prevail when it comes to public policy for CRT!”

“Without adequate funding, suppliers won’t be able to provide these very specialized products that  are essential to allow patients to stay in their homes, which is both their preferred outcome as well the cost-effective place for them to be,” said Jody Wright, president of Rocky Mountain Medical Supply and CRMC member.  “I hope that companies in the CRT space will reach out to their Senators and Representative and ask for their support for this much-needed legislation.”

In addition to showing bipartisan support, the committees of jurisdiction covering healthcare-related legislation are well-represented by current co-sponsors:

S. 486 – 5 Republican co-sponsors, 4 Democrat co-sponsors – 4 cosponsors are members of the Senate Finance Committee

H.R. 1361 – 12 Democrat co-sponsors, 10 Republican co-sponsors – 8 co-sponsors are members of the House Ways & Means Committee and 4 co-sponsors are members of the Energy & Commerce Committee.

Learn more with AAHomecare's issue brief on CRT accessories legislation.

Thursday, February 23, 2017

Reimbursement Cuts to NY Medicaid Incontinence Supplies

One Month Delay in Effect While Further Review Takes Place

Last June, The New York State Department of Health (NYS DOH) announced an ‘Incontinence Supply Management Program’ for all Medicaid beneficiaries that would implement minimum quality standards for incontinence products to take effect on September 1, 2016.  In addition to the quality standards, NY DOH also awarded a preferred vendor contract to TwinMed, LLC for incontinence products to be purchased by Medicaid providers.  Medicaid providers who purchase incontinence supplies from TwinMed, LLC were to receive competitive pricing and an approved formulary by the Department as meeting the new minimum quality standards.

While providers are not mandated to purchase these products from TwinMed, LLC, if they purchase from other vendors, they are required to obtain independent laboratory testing results certifying that the products dispensed meet the minimum quality standards. These results must be maintained by the provider for each product and kept on file for a 6-year period in the event of a pre- and/or post-pay audit.

Both AAHomecare and Northeast Medical Equipment Providers Association (NEMEP) applaud the initiative to provide high quality incontinence products to the NY Medicaid beneficiaries. However, along with these developments, the NYS DOH published fee schedule changes for these products that decreased reimbursement by approximately 30% to go into effect on February 15, 2017.

Laura Williard, AAHomecare senior director of payer relations, developed and performed a mini cost analysis study that evaluated providers’ cost of goods along with operational costs to providing these products.  This aggregate, de-identified information was presented to the Department along with comparisons of current and proposed rates with the average Medicaid allowables across the country and also with the 5 surrounding states.

Kim Voelker, NEMEP executive director, was informed that the implementation of rate reductions would be postponed until March 15, 2017 while further review takes place. Going forward, Voelker and Williard will be meeting with the Department to review the study more fully and to advocate on behalf of providers regarding the sustainability of the cuts.  Voelker comments: “Our collaboration with Laura and AAH enabled NEMEP to provide the Department with solid data illustrating providers’ true costs in supplying these products. We look forward to a continued dialogue and re-evaluation of the reimbursement model."

Wednesday, February 1, 2017

CMS Double Dips on Oxygen Payments


“Today rural America oxygen payments are lower than urban competitive bid payments - that’s egregious,” president and CEO of AAHomecare, Tom Ryan, said during his interview with DC’s News Channel8.

“CMS has used an old payment methodology and applied it to the new payment methodology, and essentially double dipped.” Ryan stressed the need to fix CMS’ misguided new cuts for oxygen concentrators in rural areas and HME’s important role in protecting patients and lessening costlier clinical interventions.

The HME industry is a service industry and very often when patients who have difficulty getting in and out of their home receive a visit from their oxygen technician or their respiratory therapist, it’s a life line for them. “That’s the ability for that provider to go in, provide the service, and give them the needed medical equipment. And very often [patients] look forward to their oxygen delivery. They like that interaction with the delivery tech when they come in their door.” This interaction and in home visit is an important part of the healthcare safety net that is now becoming more difficult to provide.

Ryan described the need for rational conversations with CMS with good data and a conversation on where homecare can help save Medicare dollars and still provide better care. “Service is the key here and we too often look at things in DC, and particularly at CMS, in silos. We’ve got to break the silos down and not just look at what does it cost you here but what does it cost you across the whole continuum of care.”

View the full interview: http://wjla.com/news/news-talk/the-affordable-care-act-medicare