Friday, May 19, 2017

DMEPOS RAC to Look at Potential Underpayments for Group 3 Wheelchair Options & Accessories

The industry is pleased to see that Performant Recovery, the DMEPOS RAC, has been approved to add an audit that will look at the underpayment of Group 3 power wheelchair options.  All wheelchair accessories (including seating systems) and seat and back cushions furnished in connection with Group 3 complex rehabilitative power wheelchairs will be reviewed regardless of modifiers.  This issue recovers the incorrect reductions owed to suppliers for claims for these items for DOS 1/1/2016 - 6/30/2016.

This is a very positive development as it is the first time an underpayment for our industry has been audited!

Monday, May 8, 2017

Industry Advocate Kucka To Receive Award at #AAHWLC17

AAHomecare is pleased to announce George Kucka will be the recipient of this year’s AAHomecare/Mal Mixon Legislative Advocate Award at our upcoming Washington Legislative Conference on May 24-25, 2017 in Washington, DC.

The Legislative Advocate Award was established in 2012 to recognize and honor AAHomecare members who have significantly advanced the homecare community’s legislative goals and who have, by their example, inspired and motivated others to join the fight for better federal policy for the home medical equipment sector. Last year the Association honored Thad Connally, president of First Choice Medical.

George Kucka, president of Fairmeadows Home Health Center, Inc. in Schererville, Indiana, has dedicated his career to serving others. As a member of the AAHomecare Board of Directors, chair of the HME/RT Council, and active member of several of the Association's Councils and Work Groups, he has been deeply involved in the decisions that are building a better future for HME.

Kucka has faithfully championed the benefits of membership in both national and state associations and served as a catalyst for action in the industry, including serving as a driver behind the efforts to develop a definition that more fully encompasses the value of HME that will have wide effects and applications in our field. His knowledge of industry processes and protocol have helped identify opportunities to pursue better systems for providers to serve patients and their communities.

The 2017 AAHomecare/Mal Mixon Legislative Advocate Award will be presented to Kucka during the Legislative Conference on Wednesday, May 24, in the Grand Ballroom at the Washington Court Hotel in Washington, DC. Register today for the conference and be there to support a colleague and strong advocate for this industry.

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.