Wednesday, August 10, 2011

Medical Supplies Council Pushes Full Agenda

AAHomecare’s Medical Supplies Council focuses on HME policy issues that affect audit, payment and coverage issues related to diabetes, wound care and incontinence issues. The Council has worked on the following issues: ostomy claim denials, surgical dressings policy coverage, negative pressure wound therapy (NPWT) accreditation standards and the issue of inadequate documentation from physicians in the diabetes space.

  • Most recently regarding NPWT, AAHomecare and Council members have met with the White House, the Centers for Medicare and Medicaid Services (CMS), the Food and Drug Administration and members of Congress on the need to establish accreditation standards for NPWT and have received unanimous support for this initiative. The Association continues to work closely with other NPWT stakeholders including the Advanced Medical Technology Association and the Alliance for Wound Care Stakeholders. The Association has also worked closely with members of Congress on Congressional sign-on letters to CMS supporting NPWT standards and AAHomecare continues to work closely with those offices. In early August, House and Senate Congressional sign-on letters were sent to CMS Administrator Berwick urging the agency to implement accreditation standards for NPWT providers.
  • In the ostomy space, AAHomecare and council members have been reviewing the ostomy supplies policy regarding concerns about patient claims of denials for ostomy orders. The Association sent a letter at the end of July to all DME MAC medical directors and to medical specialists at CMS calling for a review of the ostomy supplies policy asking for greater flexibility with claims, taking into consideration the medical need of ostomy patients especially when the “usual maximum amount” is insufficient. AAHomecare worked closely with the United Ostomy Associations of America, on this initiative, who endorsed our letter.
  • On the issue of diabetes, the Association is working with Council members to review educational materials for prescribing diabetes supplies and has proposed recommendations to address concerns with physicians’ inadequate documentation. These recommendations will be submitted to all DME MAC medical directors.
  • As far as surgical dressings policy is concerned, council members are collecting data on affected Medicare beneficiaries regarding the types of surgical dressings that are used in order to effect change with the DME MAC medical directors so as to eliminate restrictions on current policy coverage.
  • Managed Care/Insurance Coverage/State Issues: The Medical Supplies Council also monitors Medicare, Medicaid, managed care and other insurance coverage issues and reviews cases where medical supplies and related services and accessories are not appropriately reimbursed. Medical Supplies Council members are actively engaged on state issues and AAHomecare updates council members regularly on state Medicaid reimbursement and state competitive bidding news affecting the medical supplies sector.

The Council is chaired by Raymond Kreiger, Vice President, Contracts and Pricing with Byram Healthcare and the Council’s vice chair is Laura McIlvaine, Vice President, Government Affairs, Shield Healthcare.

“AAHomecare updates the council on pertinent issues in the medical supplies space. The council reviews a legislative and/or regulatory strategy for moving forward on any given issue from competitive bidding and audit matters to specific reimbursement and coding and coverage issues which is why council membership is a valuable way to address matters that are of concern to council members.” said Kreiger.

For more information about the Medical Supplies Council contact Alex Bennewith, or (703) 535-1891.

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