tag:blogger.com,1999:blog-57037365510170693242024-03-19T00:01:16.998-04:00AAHomecare BlogThe American Association for Homecare is the voice for homecare in Washington. AAHomecare lobbies Congress, the White House, the Centers for Medicare and Medicaid Services (CMS), and other agencies to improve federal policy as it relates to Medicare, Medicaid and other health care issues that affect the millions of Americans who require medical care in their homes.AAHomecarehttp://www.blogger.com/profile/12404878973597039092noreply@blogger.comBlogger299125tag:blogger.com,1999:blog-5703736551017069324.post-23573807888833598692017-09-26T16:27:00.000-04:002017-09-26T16:27:24.369-04:00Unmanageable Medicare Cuts Put Another HME Out of BusinessAs <a href="http://www.hmenews.com/also-noted/hme-provider-closes-due-cuts" target="_blank">reported recently in HME News</a>, Northern Rehab Equipment & Respiratory closed after 19 years serving the community. AAHomecare reached out to Stephanie Schwartz PT, ATP, CAPS, to understand the full story and to share her experience. She said the following:<br />
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“Yes, the reimbursement rates and policies had a huge effect on my business and is why I closed. Just to summarize the recent events for you: I am a very proactive owner and I like to make business decisions in advance of changes of sales and circumstance if possible. I owned three stores in the area at one period of time. Downsized to decrease cost since it is more expensive to provide products and services over the distances rural providers have to go.<br />
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At my Redding store, when we saw the cuts coming we made models to predict if we could stay with our current overhead and staffing and make ends meet. We could not, according to the models, so we began to change. I have been in business almost 20 years here in Redding and I was well aware that any poor decision could affect my retirement as I am 62 years old. So, we sold some areas of business that were getting too difficult to manage due to so many rules for documentation, qualification and constant changes in reimbursement and constant audits.<br />
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We sold our Rehab Division to National Seating and Mobility. Five of my employees went with them, so I felt good about retaining those jobs for them with a good new employer. We then had the first round of cuts in January, surprisingly we did okay and we were still profitable and doing a lot of business. We were adding more retail sales due to the fact in our town many providers had stopped providing beds due to the severe audits and strict, arduous qualifications. <br />
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Physicians were not willing to rewrite notes three and four times to get the documentation right so providers just stopped providing beds through insurance. We picked up more retail sales that seemed to help balance out the initial 20% cut. <br />
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When it appeared that there was to be no reprieve from the next 25% cuts in July, we again did models and reassessed our profit on individual items to see which ones would be profitable to sale. WOW those were huge, unmanageable cuts that Medicare made in July. The cuts ranged from 25%-45% off the 20% cuts made in January.<br />
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I made the decision then to do a soft close of my business because so few items were going to show a profit and the delivery costs for a rural provider are so much more. We added an Accessible Living Division a few months before the July cuts, selling ramps, lifts and bathroom inserts and remodels and were hoping to survive on mostly cash and retail sales and this new division. We cut staff again, as the cuts in July began and decided to sell off our respiratory division. We managed to stay in business almost 12 months after closing the respiratory division by getting some VA accounts for our ramps and lifts. But ultimately, I knew we could not survive, so we closed in August 2017. <br />
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I did go not bankrupt, I paid all my bills and said good bye to some faithful customers, managed to find jobs for almost all the staff. I always followed the Medicare rules and guidelines but the new qualification rules, audits, documentation, reimbursements are not made to be sustained by small businesses. Unable to purchase products at the reduced bulk cost of a larger business, our gross profit was always less than a larger business. This along with the effect the reimbursement cuts had and the cost of accreditation and audits was the reason we could ultimately not continue.”<br />
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Stephanie went further to say that she would like to own a small business again, clarifying, “one where there is a more equal playing field, one where I do not have to fight the government and prove every day I am not a fraud, a thief, a criminal or prove that I provide a worthy service to others. My new business will add value to my community. My new business will provide an excellent service or/and product. I will not be a whipping boy of Medicare ever again. I am not angry or sorry for myself, I am simply a small business owner who used simple math to figure out the reimbursement schedule, weighed against the costs of doing business with Medicare was not sustainable for my business.”AAHomecarehttp://www.blogger.com/profile/12404878973597039092noreply@blogger.com0tag:blogger.com,1999:blog-5703736551017069324.post-40179175640307700872017-09-21T09:00:00.000-04:002017-09-21T09:00:18.466-04:00Concerns Continue for Access to Durable Goods at State Level<div style="background-color: white; color: #1a1a1a; font-family: Georgia, "Times New Roman", Times, serif; font-size: 13px; margin-bottom: 15px; padding: 0px;">
<i>Access Press </i>published a piece on the plight of homecare providers in Minnesota and a current law requiring Minnesota to bid out incontinence products:</div>
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The Midwest Association of Medical Equipment Suppliers (MAMES), its members and other advocates are asking to overturn a law requiring Minnesota to bid out incontinence products. The law was tucked into the 2017 health and human service omnibus bill in the final hours of the legislative session. Bill Amberg, who is MAMES’ lobbyist, said member medical supply dealers are frustrated that the bill addition came without debate or discussing. “There wasn’t even a conversation with stakeholders.”</div>
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MAMES and its allies are working to overturn the bid requirement before it takes effect next year. That could happen during the 2018 legislative session.</div>
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Amberg said that if the change goes into effect next year, it would be yet another blow to Minnesota’s medical supply and durable medical equipment providers. More than half a dozen companies have closed during the past year including longtime Twin Cities firm Key Medical Supply. Key had waged a long and ultimately unsuccessful legal battle over the Centers for Medicare and Medicaid Services’ (CMS) competitive bidding program as it related to enteral nutrition supplies or feeding tubes.</div>
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It will also inconvenience many people who need the incontinence supplies for daily living. “It just gets tougher for people with disabilities and senior citizens,” Amberg said. “They can’t find caregivers, they can’t have reliable supplies and medical equipment for their daily lives. It’s hard to talk about people staying in their home communities on one hand and forcing them out on the other.”</div>
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<a href="http://www.accesspress.org/blog/2017/09/08/durable-goods-access-changes-concerns-go-on/" target="_blank">The full article can be found here</a>.</div>
AAHomecarehttp://www.blogger.com/profile/12404878973597039092noreply@blogger.com0tag:blogger.com,1999:blog-5703736551017069324.post-24689144957860073022017-07-06T08:55:00.003-04:002017-07-06T08:55:24.539-04:00Stemming the Tide Through Payer RelationsAs reported in <a href="http://mailchi.mp/aahomecare/wiw-july-5-17?e=119606f057" target="_blank">Wednesday in Washington</a>, AAHomecare remains focused on legislative and regulatory strategies to move the industry forward. But our investment in payer relations has also produced impressive returns for HME providers in our first year focusing on this area.<br />
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“With increasing pressure to save money on state budgets, it’s critical that we have a strong capability to help respond to proposed Medicaid rate cuts and rally providers and state associations to advocate for fair reimbursement policies,” explains Tom Ryan, AAHomecare’s president and CEO.<br />
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In just one year, AAHomecare has been successful in stemming the tide and in some cases reversing further cuts with the help of state associations, utilizing a multi-pronged approach. Here are just a few results:<br />
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<ol>
<li>With the aid of AAHomecare’s Dobson DaVanzo Study which analyzes the full operational costs plus cost of goods against the current Medicare reimbursement environment, the industry has effectively negotiated pricing agreements for DMEPOS providers with state and national payers. </li>
<li>The Association consulted with legal staff on how the CURES Bill impacted TRICARE, Medicare Advantage, and Managed Care payers. AAHomecare provided a reference for the industry to use in discussions with payers on getting July-December 2016 claims reprocessed. The Association also worked with Brown & Fortunato to obtain legal opinion on the rights and responsibilities of the states in implementing CURES language.</li>
<li>Over the course of the year, AAHomecare has built relationships with many private payers that directly impact the health of our industry and future reimbursement decisions. On the national level, payers included Anthem, TRICARE, the Defense Health Agency, AIM Sleep Management, and Carecentrix. We believe these relationships will build to greater impact on policy and operational changes for HME providers.</li>
<li>At the state level, AAHomecare has worked with regional associations to secure wins in several states who were following suit with Medicare reimbursement. These include working with NEMEP to secure a freeze of current rates until further notice with the New York Medicaid Incontinence Program. AAHomecare also joined Big Sky Association of Medical Equipment Suppliers to evaluate strategy and create a white paper for presentation to BCBS Montana regarding reimbursement cuts to the 2017 fee schedule. Further, in conjunction with the Maryland-National Capital Homecare Association, AAHomecare worked to establish a strategy for fighting pricing cuts with DC Medicaid. We have received notice the Agency is evaluating the information given and analyzing the budget before finalizing decisions, but expect changes to be made.</li>
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<span style="color: #cc0000;"><b>Williard Elevated to Vice President Role</b></span><br />
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These efforts on behalf of AAHomecare have been led by AAHomecare’s Laura Williard, who the Association has just promoted to Vice President of Payer Relations. “Laura Williard has brought significant expertise and energy to her role as leader of our payer relations efforts,” said Ryan. “She has gained a great deal of credibility with HME providers and has established solid relationships with state healthcare stakeholders and other major payer organizations.”<br />
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You can read a more extensive review on payer relations efforts and the work of Laura Williard <a href="http://mailchi.mp/aahomecare/wiw-july-5-17?e=119606f057" target="_blank">here</a>.<br />
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Laura can be reached at <a href="mailto:LauraW@aahomecare.org">LauraW@aahomecare.org</a> – and follow her on Twitter: <a href="http://williardlaura/" target="_blank">@WilliardLaura</a>.AAHomecarehttp://www.blogger.com/profile/12404878973597039092noreply@blogger.com0tag:blogger.com,1999:blog-5703736551017069324.post-58412652696426497822017-06-26T10:55:00.000-04:002017-06-26T10:55:26.060-04:00CMS Announces Long-Term Relief on CRT Accessories<b><span style="color: #990000;">Policy Change Marks an Important Win for CRT Providers and Patients Who Depend on Highly Specialized Mobility Products</span></b><br />
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The Centers for Medicare & Medicaid Services announced that accessories for group 3 power Complex Rehab Technology (CRT) mobility products will continue to remain exempt from the application of competitive bidding derived pricing for Medicare beneficiaries. Congress has twice passed legislation delaying the application of bidding derived pricing, including a six-month delay as part of last December’s CURES bill that was set to expire on June 30. This policy change, <a href="https://www.cms.gov/Center/Provider-Type/Durable-Medical-Equipment-DME-Center.html?utm_source=" target="_blank">announced here by CMS</a>, essentially extends the CURES provisions indefinitely. From CMS’ announcement:<br />
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<i>CMS is issuing a new policy on how adjustments to the fee schedule based on information from competitive bidding programs apply to wheelchair accessories and back and seat cushions used with group 3 complex rehabilitative power wheelchairs. Section 16005 of the 21st Century Cures Act currently allows higher payments for these items but is set to expire after June 30, 2017. By continuing these higher payments, this new action will help to protect access to complex rehabilitative power wheelchair accessories on which people with significant disabilities depend.</i><br />
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The full release and AAHomecare president Tom Ryan's remarks on this issue can be found in the <a href="https://www.aahomecare.org/press/cms-exempts-crt-accessories-from-bidding-derived-pricing" target="_blank">Association's press release</a>.AAHomecarehttp://www.blogger.com/profile/12404878973597039092noreply@blogger.com0tag:blogger.com,1999:blog-5703736551017069324.post-4515324678911778952017-05-19T12:09:00.000-04:002017-05-19T12:14:12.263-04:00DMEPOS RAC to Look at Potential Underpayments for Group 3 Wheelchair Options & AccessoriesThe industry is pleased to see that <a href="https://www.dcsrac.com/IssuesUnderReview.aspx" target="_blank">Performant Recovery</a>, 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.<br />
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This is a very positive development as it is the first time an underpayment for our industry has been audited!AAHomecarehttp://www.blogger.com/profile/12404878973597039092noreply@blogger.com0tag:blogger.com,1999:blog-5703736551017069324.post-31643364950491238132017-05-08T08:20:00.000-04:002017-05-08T08:27:58.239-04:00Industry 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 <a href="https://www.aahomecare.org/advocacy/legislative-conference" target="_blank">Washington </a><a href="https://www.aahomecare.org/advocacy/legislative-conference" target="_blank">Legislative Conference on May 24-25</a>, 2017 in Washington, DC.<br />
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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.<br />
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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.<br />
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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.<br />
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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. <a href="https://www.aahomecare.org/advocacy/legislative-conference" target="_blank">Register today</a> for the conference and be there to support a colleague and strong advocate for this industry.AAHomecarehttp://www.blogger.com/profile/12404878973597039092noreply@blogger.com0tag:blogger.com,1999:blog-5703736551017069324.post-71395121185825604602017-04-24T10:30:00.000-04:002017-04-24T10:30:09.436-04:00 Call for Action: Help Stop "Double Dip" Cuts for Stationary Oxygen by Reaching Out to Capitol HillRural 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.<br />
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AAHomecare has raised concerns about the issue in <a href="https://s3.amazonaws.com/aafh/downloads/1041/AAH_Comment_Letter_2017_DMEPOS_Fee_Schedule_Oxygen.pdf?utm_source=" target="_blank">a letter</a> 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.<br />
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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:<br /><br />
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<ol>
<li>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. </li>
<li>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.</li>
<li>The 2017 adjusted fee schedule payments for stationary oxygen equipment must be consistent with those based on regional average SPAs from CBAs.</li>
<li>How these cuts affect your business and patients.</li>
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If you need assistance crafting your message or contact information for healthcare legislative assistants in House & Senate offices, please contact Gordon Barnes at <a href="mailto:gordonb@aahomecare.org">gordonb@aahomecare.org</a>. Please also see our <a href="https://s3.amazonaws.com/aafh/downloads/1050/E1390_comparison_RURAL_TO_REGIONAL_TO_CBAS_010117.pdf?utm_source=" target="_blank">comparison of the rural and non-bid area rates to selected bid area rates</a> for more perspective.AAHomecarehttp://www.blogger.com/profile/12404878973597039092noreply@blogger.com0tag:blogger.com,1999:blog-5703736551017069324.post-38686514300978077042017-04-20T11:35:00.004-04:002017-04-20T11:36:50.732-04:00Share Your Expertise at MedtradeAAHomecare 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 <a href="http://www.medtrade.com/conference/speaker-resource-center.shtml" target="_blank">submit a proposal to present at Medtrade</a>. 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.<br />
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The show will take place <b>October 23-26, 2017 in Atlanta, Ga</b>. 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 <a href="http://www.surveygizmo.com/s3/3451702/2017-MEDTRADE-CALL-FOR-PRESENTATIONS" target="_blank">submit online</a>, or email Toni Ward, conference manager with questions at <a href="mailto:antoinette.ward@emeraldexpo.com">antoinette.ward@emeraldexpo.com</a>.<br />
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<b>#AAHWLC2017 </b>AAHomecarehttp://www.blogger.com/profile/12404878973597039092noreply@blogger.com0tag:blogger.com,1999:blog-5703736551017069324.post-61189492805750571742017-03-09T14:53:00.001-05:002017-03-09T14:53:42.885-05:00Legislation Introduced for CRT Accessories Has Strong Bipartisan SupportLegislation 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.<br />
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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.<br />
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“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.”<br />
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“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."<br />
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“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!”<br />
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“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.”<br />
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In addition to showing bipartisan support, the committees of jurisdiction covering healthcare-related legislation are well-represented by current co-sponsors:<br /><br />
S. 486 – <a href="https://www.congress.gov/bill/115th-congress/senate-bill/486/cosponsors?" target="_blank">5 Republican co-sponsors, 4 Democrat co-sponsors</a> – 4 cosponsors are members of the Senate Finance Committee<br /><br />
H.R. 1361 – <a href="https://www.congress.gov/bill/115th-congress/house-bill/1361/cosponsors?" target="_blank">12 Democrat co-sponsors, 10 Republican co-sponsors</a> – 8 co-sponsors are members of the House Ways & Means Committee and 4 co-sponsors are members of the Energy & Commerce Committee.<br /><br />
Learn more with AAHomecare's <a href="https://s3.amazonaws.com/aafh/downloads/1063/CRT_Accessories_Issue_Brief_03_06_07.pdf?" target="_blank">issue brief on CRT accessories legislation</a>.AAHomecarehttp://www.blogger.com/profile/12404878973597039092noreply@blogger.com0tag:blogger.com,1999:blog-5703736551017069324.post-5962501226891596922017-02-23T08:27:00.000-05:002017-02-23T08:27:06.991-05:00Reimbursement Cuts to NY Medicaid Incontinence Supplies<i>One Month Delay in Effect While Further Review Takes Place<br /></i><br />
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. <br />
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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. <br />
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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. <br />
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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. <br />
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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."<br />
<br />AAHomecarehttp://www.blogger.com/profile/12404878973597039092noreply@blogger.com0tag:blogger.com,1999:blog-5703736551017069324.post-50457709721404698992017-02-01T12:44:00.000-05:002017-02-01T12:44:57.019-05:00CMS Double Dips on Oxygen Payments <div class="separator" style="clear: both; text-align: center;">
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“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.<br />
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“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.<br />
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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.<br />
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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.”<br />
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View the full interview: <a href="http://wjla.com/news/news-talk/the-affordable-care-act-medicare">http://wjla.com/news/news-talk/the-affordable-care-act-medicare</a>AAHomecarehttp://www.blogger.com/profile/12404878973597039092noreply@blogger.com0tag:blogger.com,1999:blog-5703736551017069324.post-56824649502907050792017-01-25T14:25:00.001-05:002017-01-25T14:25:56.528-05:00Our Fight for HME in Washington Takes Many ShapesA strong voice in Washington is necessary to combat the continued regulatory and legislative battles for homecare – as well as new issues which crop up like the changes from CMS to the 2017 fee schedule for stationary oxygen. AAHomecare is your champion in the halls of Congress and the offices at CMS. We are leading the charge on policy and advocacy in a variety of ways, and one of those is through the use of strong media placements. In 2016, more than seven million people were reached with the positive message of homecare and the detrimental effects of the bidding program.<br />
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While the association will do everything in our power to be a strong voice on these issues, having the opportunity to continue working with the media to share provider’s stories helps support the work of industry lobbyist and builds on the education we are providing lawmakers.<br />
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These are just a few examples from October alone, of providers and professional healthcare reporters who understand this issue and are reaching out to lawmakers through the power of print:<br />
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<ul>
<li>10/3- Real Clear Health: <a href="http://www.realclearhealth.com/articles/2016/10/03/competitive_bidding_is_killing_medicare_beneficiaries_110132.html" target="_blank">Competitive Bidding Is Killing Medicare Beneficiaries</a> by Chris Parkin </li>
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<li>10/5- The Hill: <a href="http://thehill.com/blogs/congress-blog/healthcare/299125-congress-must-roll-back-cuts-in-reimbursement-rates-to-medical" target="_blank">Congress must roll back cuts in reimbursement rates to medical equipment providers</a> by Kelly Buckland </li>
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<li>10/17- Inside Sources Posted to Politics: <a href="http://www.insidesources.com/as-homecare-industry-confronts-medicare-cuts-upton-may-be-roadblock-to-fix/" target="_blank">As Homecare Industry Confronts Medicare Cuts, Upton May Be Roadblock to Fix</a> by Shawn McCoy </li>
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<li>10/19- <a href="http://www.valdostadailytimes.com/opinion/columns/medicare-reimbursement-cuts-affect-business/article_18f21470-4ada-5e35-8806-a8b6f3c30994.html" target="_blank">Valdosta Daily Times: Medicare reimbursement cuts affect business</a> by Ed Cockman</li>
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<li>11/15- Washington Examiner: <a href="http://www.washingtonexaminer.com/how-long-will-congress-wait-to-help-medicare-seniors/article/2607394" target="_blank">How long will Congress wait to help Medicare seniors?</a> By Tom Ryan </li>
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In addition, our media outreach efforts led to positive editorials in the Las Vegas Review-Journal and the Janesville Gazette (Wisc.), Speaker Paul Ryan’s hometown paper.<br />
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One of the ways we support the media efforts is through our <a href="https://www.aahomecare.org/advocacy/stand-up-for-homecare" target="_blank">Stand Up for Homecare</a> campaign. As Jeffrey Hall, President and CEO of <a href="http://www.reliamed.com/" target="_blank">Reliable Medical Supply</a> explains, “If you’re headed to Medtrade then you should be attending the American Association for Homecare event “Stand up for Homecare.” When you purchase your tickets to this great event you are not only buying an opportunity to meet knowledgeable industry leaders, you’re supporting the AAH continued efforts to fight our battles in Washington. Our organization looks forward to this event every Medtrade.”<br />
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Won’t you join Reliable Medical Supply and other leaders at this event and support the continued efforts to fight our battles in Washington? These stories in local and national news are making a difference in our fight for fair reimbursement and against regulatory overreach. Learn more about the <a href="https://www.aahomecare.org/advocacy/stand-up-for-homecare" target="_blank">Stand Up for Homecare campaign</a> and how <a href="https://www.aahomecare.org/membership" target="_blank">AAHomecare fights for you</a>.<br />
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To share your story and help AAHomecare explain the effects of regulatory overreach and competitive bidding on HME providers and patients, please contact Tilly Gambill at <a href="mailto:tillyg@aahomecare.org">tillyg@aahomecare.org</a> or fill out the <a href="https://aahomecare.wufoo.com/forms/-supplier-changes-in-light-of-71-medicare-cuts/?utm_source=Members-Only+Updates&utm_campaign=994e1bb71e-WiW_Dec_14_2016&utm_medium=email&utm_term=0_b7e8527839-994e1bb71e-97426517" target="_blank">online form</a>. Please be assured that all requests for confidentiality will be maintained, and that we will seek prior approval for using any material in media outreach or editorials.AAHomecarehttp://www.blogger.com/profile/12404878973597039092noreply@blogger.com0tag:blogger.com,1999:blog-5703736551017069324.post-81405437027513843142017-01-19T13:31:00.002-05:002017-01-19T13:31:59.260-05:00What's Next? - A Message From AAHomecare's President
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhfpFHsbH_vP2hqzaRRO_2TI56H7wgeqlUK5cN52Xu1qCw66oDlNvuAz54G6a7rxu1SxNRrJxZ-khFTuO_jREcDBh4SrJ0a5M09kZ6TT75P9pRqpUi2ZK4e5CNWVofrISI36deiQieNbcOA/s1600/Tom_Ryan.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhfpFHsbH_vP2hqzaRRO_2TI56H7wgeqlUK5cN52Xu1qCw66oDlNvuAz54G6a7rxu1SxNRrJxZ-khFTuO_jREcDBh4SrJ0a5M09kZ6TT75P9pRqpUi2ZK4e5CNWVofrISI36deiQieNbcOA/s320/Tom_Ryan.jpg" width="256" /></a></div>
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As we start the New Year, with a new Congress just getting settled in and a new Presidential Administration beginning in just a couple days, AAHomecare has hit the ground running to ensure we can build on last year’s legislative and regulatory successes and capitalize on potential opportunities for even better public policy outcomes for HME in 2017. I’d like to give you a quick rundown on what we’ve been focusing on at the start of the year to make that happen.</div>
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<b>Rural O2 Payment Policy – </b>As we've <a href="http://us1.campaign-archive1.com/?u=3c0f3755f13930464597f245a&id=bf83c79e81&e=b4730b58fe&utm_" target="_blank">recently reported</a>, AAHomecare has asked CMS to reconsider their changes to the 2017 fee schedule for stationary oxygen, resulting from the misguided combination of a 2006 offset balancing rates for portable and stationary oxygen with bidding-derived pricing for rural providers. While we’ve continued to attempt to engage CMS on this issue, we are now reaching out to Capitol Hill to alert them to this issue and ask them to get involved and are also planning media/PR outreach on the issue if it not quickly resolved.</div>
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<b>Competitive Bidding Program – </b>Last year’s success in getting a measure of relief for rural providers for July through December of 2016 will certainly be welcomed by providers when CMS finally announces a refund process (more on that in a moment), but a longer-lasting solution is critically needed. While our champions on Capitol Hill have expressed their willingness to take up the fight for fairer rural relief policy in the 115th Congress, we’re all too aware of how slowly that process can move. To that end, we brought in a sub-group of AAHomecare’s Regulatory Council to explore and develop regulatory actions the new administration could take to provide relief for rural providers, especially given that the recent CURES legislation will require HHS to reissue payment regulations to take effect by the start of 2019. </div>
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<b>Reimbursements from Other Payers – </b>We believe that other payers who base their rates on the Medicare fee schedule should provide commensurate retroactive relief for the July 1-Dec. 31 period, where applicable. We are currently working on our messaging to make this case to TRICARE and Medicare Advantage plans.</div>
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<b>Where’s the Refund? –</b> As I noted above, HME providers in rural and non-bid areas are anxiously awaiting word on the procedures and timing for the relief mandated in the CURES Act – it’s certainly a question that the AAHomecare staff has heard repeatedly from our members and other HME stakeholders. We’ve pressed CMS to provide guidance as soon as they can, and you can be sure we’ll share that news with you as quickly as we get it.</div>
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<b>We’re Just Getting Started – </b>While AAHomecare helped deliver important gains for the HME community in 2016, we recognize that the HME industry still faces a reimbursement and regulatory environment that is causing many well-established companies to change their business models or shutter their operations – leaving patients and communities with less access to essential home medical equipment. Be assured that the current AAHomecare team enters 2017 with a renewed commitment to improving the business environment for HME through continued advocacy work on Capitol Hill and at CMS, by building relationships with non-Medicare payers, and by exploring new approaches to reimbursement models for value-based approaches and emerging technologies. I truly believe this will be our most productive and effective year yet, and I look forward to working with the AAHomecare membership and other HME stakeholders to make it happen. </div>
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To learn more about the work of the American Association for Homecare, or to join us, please visit <a href="http://www.aahomecare.org/">www.aahomecare.org</a> or contact Michael Nicol at <a href="mailto:michaeln@aahomecare.org">michaeln@aahomecare.org</a>. </div>
AAHomecarehttp://www.blogger.com/profile/12404878973597039092noreply@blogger.com0tag:blogger.com,1999:blog-5703736551017069324.post-62732210589604783722016-12-02T09:15:00.000-05:002016-12-02T09:24:02.038-05:00Glimmer of Hope for HME- CURES Bill Passes and Rep. Price Named HHS SecretaryThis week the House of Representatives passed the 21st Century Cures Act, by a vote of 392 to 26. The bill is expected to move to the Senate next week and the Obama Administration has already weighed in <a href="https://www.whitehouse.gov/sites/default/files/omb/legislative/sap/114/saps34s_20161129.pdf?" target="_blank">expressing support for the legislation</a>.<br />
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The legislation sets the stage for possible future regulatory relief for rural providers, as it requires HHS to reissue payment regulations for items and services furnished on or after January 1, 2019, with adjustments to the non-bid fee schedule in some areas based on stakeholder input, costs, volumes, and numbers of suppliers serving those areas.<br />
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Specifically, the legislation will provide six months’ worth of retroactive relief for the second phase of bidding-derived cuts for rural and non-bid area providers; delays the application of bidding-derived pricing reductions for complex rehab technology accessories used with Group 3 power wheelchairs for an additional six months; accelerates the application of plans to limit state Medicaid reimbursement amounts for HME to the Medicare fee-for-service payment rates, including applicable competitive bidding rates, by one year, to Jan. 1, 2018; and also instructs HHS to conduct a study on the impact of the bidding program on the overall number of HME providers and availability of HME products over the course of 2016.<br />
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While AAHomecare and other HME stakeholders advocated for a longer delay for the second phase of bidding derived cuts, this legislation marks an important step in efforts to scale back the effects of the bidding program. Both chambers of Congress, along with party and committee leadership, have recognized that the home medical equipment community in rural areas needs relief and that the bidding program requires more scrutiny. <br />
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These measures set the stage for working with the new Administration to move towards more sustainable Medicare reimbursement policies for all HME providers, as well as again taking up these issues in the 115th Congress.<br />
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Also this week, President-elect Donald Trump announced he will appoint <a href="https://www.washingtonpost.com/news/powerpost/wp/2016/11/28/trump-to-name-rep-tom-price-as-next-hhs-secretary/?utm_term=.2bc2fcc40545" target="_blank">Congressman Tom Price (R-Ga.) to serve as Secretary of Health and Human Services</a> in his Administration. Price, who has represented Georgia’s 6th Congressional District since 2004, has been a consistent advocate for better public policy in the healthcare arena and has championed legislation to make sure that patients who rely on home medical equipment have access to those products and related services.<br />
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Seema Verma, founder and president of health policy consulting firm SVC Inc., was selected to serve as Administrator of the Centers for Medicare and Medicaid Services.<br />
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AAHomecarehttp://www.blogger.com/profile/12404878973597039092noreply@blogger.com0tag:blogger.com,1999:blog-5703736551017069324.post-78273145118051885812016-11-10T13:45:00.002-05:002016-11-10T13:46:51.602-05:00Medicare Open Enrollment Tips for HME ProvidersThe Medicare open enrollment period began on October 15, 2016 and runs through December 7, 2016. It’s important to know how these plan changes will impact your patients and your company. Even though the enrollment period runs through December 7, it may take longer for many plans to update their systems.<br />
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Determining Plans Available in your Service Area</h3>
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Many insurance plans may add products or eliminate products they previously offered. There may even be new insurance plans created and offered in your areas.<br />
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This is the website that beneficiaries can use to investigate plan choices.<br />
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<a href="https://www.medicare.gov/find-a-plan/questions/home.aspx">https://www.medicare.gov/find-a-plan/questions/home.aspx</a><br />
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Providers can enter the zip code for their service area to determine which plans are available to their patients and answer the following questions.<br />
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1. How do you get your Medicare coverage?<br />
-- Select “Original Medicare”<br />
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2. Do you get help from Medicare or your state to pay your Medicare prescription drug costs?<br />
-- Select “I don’t know”<br />
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3. Select "I don’t want to add drugs now"<br />
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You can then Select “All” and “Continue to Plan Results” to obtain listing of all the plans in your service areas. This will also give you deductible and copays for durable medical equipment for each plan. <br />
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Next Steps After you have the Plans Available</h3>
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Review these plans and determine your risk as a company in plans that you are not in network with. Determine if these plans offer out of network benefits.<br />
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Develop a plan to ensure you have current insurance information on all new and existing rental patients. Develop transition plan for those patients electing a payer you are not in network with if they do not offer out of network benefits.<br />
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You can elect to send letters to all your existing rental patients informing them of open enrollment and steps they should take in informing you of insurance changes. You can suggest in this letter the plans that you are in network with as plans they may want to choose.<br />
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Evaluate if there are any big budget changes based on plans available.<br />
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Plan changes could have an impact on your revenue stream. Preparing for these can help eliminate denials and rework in your companies. AAHomecarehttp://www.blogger.com/profile/12404878973597039092noreply@blogger.com0tag:blogger.com,1999:blog-5703736551017069324.post-70344968038572377722016-10-28T12:00:00.000-04:002016-10-28T12:00:09.630-04:00Louisiana Home Medical Equipment Providers Hold Out a Lifeline to Flooded Communities<h4 style="background-color: white; color: #333333; font-family: Verdana, sans-serif; font-size: 11.44px;">
<i><span style="color: red;">(3rd Installment: Home Medical Equipment Providers Overcome Major Storms to Help Patients)</span></i></h4>
Home medical equipment (HME) suppliers have a long track record of making sure their patients get the products and services they need during natural disasters. August’s catastrophic floods in much of Louisiana provides the latest examples of the extraordinary efforts undertaken by companies to serve their communities in extremely challenging conditions.<br />
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Apria Healthcare’s employees in Louisiana have been working around the clock to ensure continuity of care for approximately 700 patients with lost or flood-damaged equipment, many of whom have had to evacuate their homes.<br />
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While Apria’s branches in Baton Rouge, Lafayette and Alexandria have been on the front lines making sure their patients are cared for, their locations in New Orleans, Shreveport, and Beaumont, TX also provided inventory. In addition, Apria is sending tractor trailers loaded with respiratory equipment to Baton Rouge to replace damaged, lost equipment and to ensure there are enough portable cylinders to accommodate ambulatory needs of their patients.<br />
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Apria’s ability to respond quickly in these situations is the result of extensive preparation and advance planning for emergency situations. Every branch at Apria has a pre-planned emergency preparedness plan, which includes identifying and contacting high acuity patients and all respiratory patients who need oxygen, and making sure they are triaged accordingly. Apria staffers also coordinate with local authorities and public safety personnel to set up staging areas to meet patients if they are displaced to receive services.<br />
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“These unique situations require an extraordinary effort to replace damaged or lost equipment and help keep patients intact and avoid costly hospital visits,” said Bill Guidetti, Executive Vice President, East for Apria. “From Hurricanes Katrina and Sandy to fires in the West, and now the flooding in Baton Rouge and Lafayette, Apria is on call for our patients.”<br />
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“Home medical equipment providers take great pride in helping to keep people out of hospitals and other clinical settings all year long,” added Guidetti. “This role becomes even more important during times like these when healthcare and emergency services personnel are under extra pressure.”<br />
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Many HME company personnel have been helping others while trying to deal with significant challenges themselves, as evidenced by efforts by two Respiratory Therapists (RT) with Lafayette-based respiratory services provider Viemed.<br />
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Adam North, an RT in Baton Rouge, started out the week with three-and-a-half feet of water in his home and his company delivery vehicle. Fortunately, he had bought a 20-year-old pickup truck from one of his patients the previous month. Adam worked all week driving his “new” truck, responding to calls from patients whose non-invasive ventilator equipment was damaged or left behind in the haste to escape the quickly rising floodwaters. <br />
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In many cases, he had to seek them out at a relative's house or in an emergency housing shelter. <br />
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Matt Bourg, an RT in nearby Denham Springs, had similar experiences, but fortunately did not suffer water coming into his house. Matt’s efforts included meeting up with a patient discharging from the hospital evacuating to his daughter's house. That patient had left his ventilator at home, which was under eight feet of water; Viemed replaced that equipment, and has done so in several other instances.<br />
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“We’ve replaced a lot of equipment in the last week, even though we’re not obligated to do so and it’s not clear if or how we’ll get compensated for that,” said Max Hoyt, president & CEO of Viemed. “It’s times like these that remind us that just doing the right thing is the best business practice.”<br />
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AAHomecarehttp://www.blogger.com/profile/12404878973597039092noreply@blogger.com0tag:blogger.com,1999:blog-5703736551017069324.post-36070792186127236102016-10-27T15:00:00.000-04:002016-10-27T15:00:22.079-04:00“No matter how much you prepare for an event like this you cannot completely predict the obstacles your team will face” – Family Medical Supply Tells Their Story<h4>
<i><span style="color: red;">(2nd Installment: Home Medical Equipment Providers Overcome Major Storms to Help Patients)</span></i></h4>
<i>Family Medical Supply is headquartered in Dunn, NC with 18 locations in the state. </i><br />
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While the sun rose to a clearing sky on Sunday morning, October 10, the havoc wreaked by Hurricane Matthew just a few hours before was only beginning to be realized. <br />
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"Roads were washed out in some places and completely gone in others," states Joey Tart who, along with his brother Billy, owns Family Medical Supply and its 18 North Carolina locations.<br />
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By the time emergency crews were assessing the storm's damage the Family Medical team was already at work, delivering over 300 oxygen tanks that first day to patients over thousands of square miles. <br />
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"No matter how much you prepare for an event like this you cannot completely predict the obstacles your team will face," adds Billy. "We have a very committed group who worked days on end to look after oxygen and ventilator patients. We worked with emergency services and even the National Guard in an area we couldn't access due to flooding.”<br />
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"That first day's obstacles were only the beginning of one of the longest weeks in recent memory for DME companies across the southeast. By Monday, the orders for oxygen had almost doubled and the downstream communities were suddenly coming to terms with flooding that would take out highways, interstates, and most importantly, direct access to patients. The Tart brothers had drivers that were taking three and four different routes to try to find a way to serve patients in dire need.<br />
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"It's two weeks out and we are still trying to assess the amount of lost and damaged equipment," reflects the Tart brothers report. "We have heard from the Department of Health and Human Services and from BlueCross/Blue Shield concerning how to proceed with looking after these patients. So far the only thing we've gotten from Medicare is more audits."<br />
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"We are paying hundreds of hours of overtime, working with emergency services to access patients and going the extra mile for patients that Medicare does not want to pay us for because the doctor signed or dated the orders in the wrong place. The patient visits have run into the thousands, but at this point we do not know of a single patient that had to go to the hospital because we could not get to them."<br />
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That last sentence is what is missed in the modern understanding of a DME business. An industry that is having a definite impact on hospital costs through its commitment to service is only seen as a boxed goods provider by policy makers. The most undervalued aspect of any industry is the bill that is not yet due. What would a couple of thousand extra hospital admissions cost Medicare last week? Let's hope we do not have to find out after the next hurricane. <a href="https://www.aahomecare.org/pages/deep-cuts-for-medicare-reimbursement-rates-threaten-rural-america" target="_blank">Call your congressman and ask him to roll back the ruinous cuts for HME providers serving rural communities</a>.AAHomecarehttp://www.blogger.com/profile/12404878973597039092noreply@blogger.com0tag:blogger.com,1999:blog-5703736551017069324.post-30176527694239947052016-10-26T16:29:00.000-04:002016-10-26T16:34:22.679-04:00Home Medical Equipment Providers Overcome Major Storms to Help PatientsHome medical equipment suppliers have a long track record of making sure their patients get the products and services they need during natural disasters. The recent catastrophic floods stemming from October’s Hurricane Matthew hitting the Carolinas, along with stories from the August severe flooding in Louisiana, provide compelling examples of the extraordinary efforts undertaken by companies to serve their communities in extremely challenging conditions.<br />
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This remarkable effort outlined below is the first installment of examples of home medical equipment companies providing personal and committed care to individuals with significant healthcare needs – including seniors, and people with disabilities or chronic conditions. While HME companies devote extra resources to making sure their patients are cared for in disaster situations, they do not receive extra compensation from Medicare for providing emergency services.<br />
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<b>Liberty Medical Overcomes Loss of Power and Phones, as well as Severe Travel Challenges to Serve Patients</b></h3>
<i><a href="http://www.liberty-ms.com/" target="_blank">Liberty Medical</a> is headquartered in Whiteville, NC, with nine other locations in North and South Carolina</i>.<br />
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Beginning October 3rd we began calling patients to assure they had proper back up for the equipment they had with us. For oxygen patients if they had used their back up tanks to any degree, we switched them out to assure in most cases at least two days. We also called other patients to remind them to charge any equipment they may have had that had battery backup. This included calling several hundred patients in the coastal areas as that was the areas that we had been receiving the warnings about at that time. That process took us several days to complete and many man hours and the expense of additional equipment.<br />
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On Thursday, October 6th, as the storm was approaching our coast, we felt like we were prepared. At that time weather services were saying that we would get some rain and winds up to 60 MPH and that it would be downgraded by the time it reached the North Carolina coast. Our patients are throughout North and South Carolina and each area along the coastal regions would be impacted to some degree. The South Carolina direct coastal areas at that time were under a mandatory evacuation and we had patients calling to let us know they were leaving their homes; we advised them to take what they needed with them. North Carolina was not under any evacuation orders at that time. We began taking inventories of oxygen that we had in stock and ordered more from our supplier as we were running low as a result of stocking up the patients in the areas we felt were going to be impacted.<br />
We began to get calls into our offices farther inland from patients of ours, as well as from patients of other companies seeking to get equipment that they left behind or trying to get more portable tanks while in hotels or with relatives.<br />
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On Friday, October 7th the storm began to get into our service areas with winds in some places over 60 MPH and rain. We had several offices that were in the evacuation areas to close at that time. All preparations for the storm had been completed. We felt like we were ready for what we had been told would be a category 1 or 2 storm.<br />
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We continued to monitor the storm and in most of our offices we continued to service our customers on a normal basis. The storms impact at this point was mostly high wind and heavy rain in the coastal areas.<br />
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As of Saturday the 8th the winds were picking up and the rain was continuing. It rained from Friday night until sometime Sunday afternoon. Many areas of North Carolina had received a considerable amount of rain several weeks prior to the storm which resulted in lakes, streams, swamps and creeks already being full of water. The winds took down trees and the water started rising, power started going down, and roads began to become dangerous to travel by Sunday afternoon. The inland counties by that time had received at least 16 inches of rain and the impact was just beginning. The coastal areas did not receive as much of an impact except where there was storm surge directly on the beaches. As of Sunday afternoon, our phone system went down as well as the local 911 system as a result of flooding. We also lost our ability to get into our main software system as well because of a loss of power in another section of our building. We were running on generator power at that time. We later learned that the main substation for Duke Power that powered the entire town was underwater. We had our phone carrier to override our phone system and forward all calls to a single cell phone for calls.<br />
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By Monday morning the rivers and creeks started rising and several main roads were washed out from running water. Many of our employees could not get to work as detours were not posted and traffic began to back up on several of the main highways. As some employees began to get to work as best they could, we began to evaluate our work based on having no ability to make calls using our system but only with cell phones which were working only sporadically. We could not at that time access any patient information using our software.<br />
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We put two customer service reps at our front entrance and provided them with our main incoming line cell phone and other cell phones to call patients back on without tying up that main line. We began contacting our branches to get a feel of what their circumstances were and who was open. All branches were open and had access to phones and systems. We at the home offices then got several lap-tops up and running and we were in business.<br />
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Then the calls started coming in from patients that were in shelters and needed oxygen as they left their equipment in their homes. We could get to them and provided them with oxygen. We also had several patients that came to the office as they had no phone service to get what they needed. We also had patients that at that time had been without power for two days contacting us for more backup.<br />
Our problems had only started as more roads were being closed as a result of flooding. By the end of the day on Monday we were not sure how our drivers could get to the inner part of the state as we were closed off by major highways on all sides of us. We could only go toward the coast at that time. All gas stations were closed, all stores were closed, and there was no UPS or mail service. I-95 was shut down for 30 miles, I-40 was detoured, and we had patients that needed help. Our drivers had to leave our warehouse not knowing if they could get where they were going or not. They seemed to always find a way to get where they needed to be and never complained – they just got the job done.<br />
By Tuesday there were entire towns under water and residents being evacuated. Some were our patients that we attempted to follow. We continued to provide services to our patients that we could get to. Many times we would have to go East to eventually get to the West to go around closed roads and detours.<br />
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Our information system was completely functional on Wednesday the 12th, and we got full phone service restored the next day.<br />
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We are not aware of any of our patients having to get service from another source during this hurricane as a result of many hours of hard work and the dedication of our staff. As of Tuesday the 18th we continued to have patients in shelters and we have employees that have lost their homes.<br />
As a result of what we have learned in this process and what we know about the future of companies serving rural communities, we feel this type of service may not be available for the next event when it comes. For the sake of the patients who depend on home medical equipment in good times and bad, we hope that doesn't come to pass. Congress needs to take note of the high level of service that HME companies provide and finish the job on legislation to give some relief from deep cuts for suppliers in rural communities.<br />
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<i>Visit the blog tomorrow to view a new story of an HME company devoting extra resources to make sure all of their patients are taken care of during Hurricane Matthew.</i></div>
AAHomecarehttp://www.blogger.com/profile/12404878973597039092noreply@blogger.com0tag:blogger.com,1999:blog-5703736551017069324.post-25979779142264069582016-10-04T13:03:00.000-04:002016-10-04T13:03:36.435-04:00Providers’ Stories Reveal Devastating Effects of Competitive Bidding on Businesses and Patient Access to HME<i><b>Let Us Know How Your Company Has Been Affected by the New Pricing Environment</b></i><br />
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While Congress is no longer in session, AAHomecare continues to keep legislators apprised of the challenges HME providers are facing as we pursue legislative relief for these unsustainable prices. Thank you for continuing to relay your experiences to the association.<br />
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Here are some excerpts from narratives providers have shared with us about their challenges and plans going forward:<br />
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<b>Illinois -</b> During 2016, we’ve struggled to meet budget and had a few months where our bottom line was below the break-even point. We’ve looked at our lines of business to determine where we are affected the greatest. Oxygen reimbursement has dropped drastically, and with all the expenses tied to oxygen, including tanks, supplies, 36-month cap, portability, maintenance, and salaries, we are currently reviewing if this is a viable business line to keep.<br />
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<b>Missouri -</b> We have been serving rural patients in SW Missouri for 30 years. We are a long-time valuable business and employer in our small community. The recent cuts make it impossible to adequately serve the needs of our current and future area patients. If the pricing structure doesn't change fast, we will be forced to stop serving our community and our patients. Telling patients "NO" for services they desperately need is heartbreaking. The quality of life and activities of daily living of our patients will suffer drastically and ultimately cost Medicare much more as these patients will be unable to stay in their homes and move to hospitals, assisted living facilities and nursing homes to gain the services we provide at a fraction of the cost!<br />
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<b>New Mexico -</b> Currently, we are negotiating with every vendor possible and looking for more affordable products (which are not always the same quality), extending current loans and reducing company contributions for Medical Health Insurance benefits. It is possible that we will soon need to stop vesting in the retirement plan for our employees. Sad state of affairs.<br />
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Help us continue to beat the drum on Capitol Hill by submitting your story to Tilly Gambill at <a href="mailto:tillyg@aahomecare.org">tillyg@aahomecare.org</a>.AAHomecarehttp://www.blogger.com/profile/12404878973597039092noreply@blogger.com0tag:blogger.com,1999:blog-5703736551017069324.post-70499116040820240822016-09-21T15:57:00.002-04:002016-09-21T15:57:41.227-04:00 Washington Inaction Is Hurting Seniors’ Medicare<b>Wisconsin Seniors Need Speaker Ryan to Stand Up for Them</b><br /><br />By Brian Kelly<br /><br />One would think the loss of 15 jobs and the closure of four of our nine medical equipment showrooms here in Wisconsin, is the result of an economic downturn or a slowdown in our industry. The cause is a misapplied government program that is leading to less access to care, reduced quality of care, and higher out-of-pocket costs for seniors and people with disabilities that rely on Medicare.<br /><br />Based in and around U.S. House Speaker Paul Ryan’s congressional district, our company employs over 500 hard-working and committed individuals who provide a wide range of medical services and supplies to our friends and neighbors in 23 counties across south central and southwestern Wisconsin. An important segment of our business is providing home medical equipment and quality service to seniors on Medicare.<br /><br />Across the country many rural medical equipment suppliers like us could soon be closing their doors, laying off more employees, and leaving patients with limited options and poor service. This is the result of Congress’ failure to resolve a problem created by the recently-instituted competitive bidding process on home medical equipment. Its objective is to save taxpayer dollars, an important initiative, but it has failed on multiple levels.<br /><br />The competitive bidding process was originally designed for use in urban and suburban areas, but this year, the Centers for Medicare and Medicaid Services (CMS) began applying rates from the bidding process in major metro areas to rural communities throughout the United States. The initial results from a first round of cuts saw a 20 to 25 percent decrease in reimbursement to rural providers for many items starting in January of this year. These reductions caused significant disruption for home medical equipment providers and patients. Despite these problems, CMS applied a second round of similar cuts for rural communities on July 1 that have now reduced reimbursement rates by 50 percent or more when compared to the prices in effect in 2015.<br /><br />The urban and national companies making the bids that set reimbursement rates often times specialize in one product – hospital beds or oxygen supplies for example. In the small towns and communities Home Health United serves, we do not have the volume or conveniences of urban delivery routes to support these lower rates. To make our business work in rural communities we have to provide multiple product lines and travel many miles to deliver a single unit.<br /><br />We have closed showrooms in Johnson Creek, Portage, Platteville and Madison, a significant inconvenience for countless seniors who now have to drive farther. Seniors in rural areas tend to be much older than beneficiaries in urban areas, which makes longer travel times that much more significant. Given the added travel and higher out-of-pocket costs for seniors, many Medicare beneficiaries are deciding not to purchase the medically necessary products for their home care<br /><br />Congress had a chance to pause the second round of cuts to allow for further study of the impacts on patients in rural communities, but the House and Senate were unable to reconcile different versions of legislation before they recessed in July. Wisconsin home medical equipment providers are counting on Speaker Ryan to help break the impasse and make sure seniors and people with disabilities continue to get the home medical equipment they depend on.<br />
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<br />Brian Kelly is the vice president of Home Medical Equipment & Infusion Services for <a href="https://www.homehealthunited.org/" target="_blank">Home Health United, Inc.</a>, based in Madison<br /><br />
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<br />This story appeared in the Sept. 12, 2016 print edition of the <a href="http://www.gazettextra.com/" target="_blank"><i>Janesville (Wisc.) Gazette</i></a>AAHomecarehttp://www.blogger.com/profile/12404878973597039092noreply@blogger.com0tag:blogger.com,1999:blog-5703736551017069324.post-23371034276927262412016-09-08T10:30:00.000-04:002016-09-08T10:30:33.992-04:00Tom Ryan Makes the Case for Competitive Bidding Reform on C-SPAN and SIRIUS/XMIn a continuing effort to educate Congress and share the struggle of HME providers in the current Medicare environment, Tom Ryan was interviewed on C-SPAN’s Washington Journal show on Labor Day Monday (Sept. 5).<br />
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“It’s patient preferred, it’s economically the best situation, and at the end of the day you will get a better outcome,” explained Ryan highlighting the service component of home medical equipment and the benefits of homecare. Ryan also discussed the need for competitive bidding legislation stating, “Being fiscally responsible in this town [DC] is important. The legislation we have had has been self-funded by the industry. We have been taking dollars from other areas of the industry. The last bill out there would take reimbursement from Medicare and have that become the new rate in 2019.”<br />
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If you did not watch live, you can still <a href="https://www.c-span.org/video/?414401-5/washington-journal-thomas-ryan-home-health-care" target="_blank">view the full interview online</a>.<br />
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And this morning? A stop at satellite radio – Tom appeared on SIRIUS/XM radio on The Morning Briefing with Tim Farley, which airs on their Politics of the United States (POTUS) channel (#124). "We need congress to roll back these cuts to HME," Ryan said.<br />
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There has also been great coverage of these issues in the press:<br />
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<ul>
<li><a href="http://www.insidesources.com/as-congress-returns-homecare-industry-says-urgent-action-needed-on-medicare-reimbursement/?utm_source=Members-Only+Updates&utm_campaign=cae3efc368-WiW_Aug_31_2016&utm_medium=email&utm_term=0_b7e8527839-cae3efc368-97426517" target="_blank">As Congress Returns, Homecare Industry Says Urgent Action Needed on Medicare Reimbursement</a> – InsideSources (Aug. 31)</li>
<li><a href="http://thehill.com/blogs/congress-blog/healthcare/293641-congress-should-stand-up-for-small-businesses-and-seniors-on?utm_source=Members-Only+Updates&utm_campaign=cae3efc368-WiW_Aug_31_2016&utm_medium=email&utm_term=0_b7e8527839-cae3efc368-97426517" target="_blank">Congress Should Stand up for Small Businesses and Seniors on Medicare</a> – The Hill (Aug. 30)</li>
<li><a href="https://morningconsult.com/opinions/rural-americans-medicare-will-continue-receive-inadequate-care-unless-congress-acts/?utm_source=Members-Only+Updates&utm_campaign=cae3efc368-WiW_Aug_31_2016&utm_medium=email&utm_term=0_b7e8527839-cae3efc368-97426517" target="_blank">Rural Americans on Medicare Will Continue to Receive Inadequate Care Unless Congress Acts</a> – Morning Consult (Aug. 29)</li>
<li><a href="http://thehill.com/opinion/op-ed/294893-we-all-agree-medicare-cuts-need-slow-phase-in-analysis" target="_blank">We all agree: Medicare cuts need slow phase-in, analysis</a> - The Hill (Sep. 7)</li>
</ul>
AAHomecarehttp://www.blogger.com/profile/12404878973597039092noreply@blogger.com0tag:blogger.com,1999:blog-5703736551017069324.post-63117689897692412602016-08-18T16:29:00.000-04:002016-08-19T10:04:05.245-04:00Nominate an HME Leader for the 2016 Homecare Champion AwardDo you know a champion for the HME profession? The Association is now accepting nominations for an AAHomecare member who has made an exceptional contribution to the homecare sector throughout their career. Attributes that will be recognized include:<br />
<ul>
<li>A longstanding record of service within the homecare community;</li>
<li>Embodiment of the spirit of caring and generosity which are the hallmarks of this profession; </li>
<li>Active membership and engagement in the American Association for Homecare.</li>
</ul>
While this title may relate in part to involvement in government affairs, the Homecare Champion award is not predominately focused on federal or state government advocacy. Our goal is to honor people who have been involved in various aspects of the business of HME and the care that is an essential component of it.<br />
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The recipient will be honored during the <a href="http://www.aahomecare.org/advocacy/stand-up-for-homecare" target="_blank">Stand Up for Homecare</a> reception during <a href="http://www.medtrade.com/index.shtml" target="_blank">Medtrade</a> on Tuesday, November 1, 2016 and recognized in a special notice in the trade press and local media.<br />
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Nominations can be submitted to Sue Mairena, <a href="mailto:suem@aahomecare.org">suem@aahomecare.org</a> through September 9. <br />
<a href="http://www.aahomecare.org/advocacy/homecare-champion-award" target="_blank"><br /></a>
<a href="http://www.aahomecare.org/advocacy/homecare-champion-award" target="_blank">Find the nomination form and see past honorees here.</a>AAHomecarehttp://www.blogger.com/profile/12404878973597039092noreply@blogger.com0tag:blogger.com,1999:blog-5703736551017069324.post-59671801035484041052016-08-11T16:04:00.000-04:002016-08-11T16:04:21.430-04:00Providers' Stories Foreshadow Growing Challenges for Rural Patients and Communities<b><i>Let Us Know How Your Company is Adapting to the New Pricing Environment</i></b><br />
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Thanks to the many providers in rural and non-bid areas who have reached out to share their stories about the difficult business decisions they’ve faced in light of the latest round of bidding derived cuts.<br />
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Here’s some excerpts from what providers are telling us about their challenges and plans going forward:<br />
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<ul>
<li><b>California</b> – So here we are after 27 years in the DME business and with this second set of cuts I will have to close my doors within a 45-60-day timeframe. It will not be pretty. I've had as many as 30 employees and now I have three; two of them are part time… When all this comes down I will also lose my home. Talk about having my world turned upside down.</li>
</ul>
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<ul>
<li><b>Texas</b> – 2016 marks my 20th year serving the needs of HME and supply customers. Due to the competitive bidding debacle, I’ll pack up 20-years’ worth of memories into a box and see what is next. The 20 people that hold full time jobs with me will have to be terminated. They won’t be alone, as all private HME companies serving rural areas will go out of business and lay off their employees. There will be thousands of them across Texas… Like I’ve said a thousand times, we could set up a hospital in the home for a fraction of what it costs to be hospitalized. We can provide years’ worth of oxygen therapy for what it costs for a couple days of being in the hospital. Not anymore. After July 1st, rural patients will have to beg someone for these products.</li>
</ul>
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<ul>
<li><b>Kentucky</b> – No one thinks about the cost of our equipment along with the cost to deliver and educate the patient and family that is depending on us to help a mom or dad or a loved one. We also deal with insurance guidelines, deal with insurances two to three times on a claim, and have overhead that never stops… No business can keep its doors open when you are losing money to take care of someone.</li>
</ul>
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<li><b>New York</b> – There is a much bigger picture that seems to be overlooked by government. It’s about preserving services and equipment to individuals and the elderly with severe disabilities and the livelihood of local and county businesses and residents… We are giving up any hope. The light at the end of the tunnel is about to go out.</li>
</ul>
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<ul>
<li><b>Alaska</b> – The only reason we are still in business is because we are family owned and operated. Many times we do not get a paycheck. We started this business twenty years ago because of the need for DME. We now have over 200 clients we serve. If I close the doors, they have no place to go except the hospital, which is at capacity most of the time, and the cost to Medicare will increase by 2000%. The other option is to move South. </li>
</ul>
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Our champions on Capitol Hill and other members of Congress and staffers have asked us to collect and share as many real world examples of how the new pricing environment is affecting providers and patients in rural and non-bid areas. We hope you’ll consider adding your story to the mix.<br />
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Please help us make the strongest case possible as we prepare to advocate for relief for rural and non-bid area providers in September. Contact Tilly Gambill at <a href="mailto:tillyg@aahomecare.org">tillyg@aahomecare.org</a> to share your story, or with any questions.AAHomecarehttp://www.blogger.com/profile/12404878973597039092noreply@blogger.com0tag:blogger.com,1999:blog-5703736551017069324.post-2987297110356610732016-08-01T09:30:00.000-04:002016-08-01T09:30:09.481-04:00Encourage Referral Sources to Take Survey on Effects of Bidding ProgramAAHomecare has deployed a survey for medical professionals and related support staff (including hospital discharge planners, care managers and social workers) asking for information on their experiences in getting medically-necessary HME products for their patients in a timely manner. The brief survey gives medical professionals the opportunity to share their perspectives on issues they may have faced on account of reduced availability of HME in a changing competitive environment. AAHomecare asks suppliers to share the survey with their referral sources as soon as they can.<br />
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The Association plans to use the data to support legislative efforts to demonstrate the effects of recent deep cuts for Medicare reimbursement stemming from the rates created by the latest round of the competitive bidding program, both for companies located in competitive bidding areas, as well as those in rural and non-bid areas that are subject to pricing derived from that program.<br />
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A printable version of the survey is available at <a href="https://www.aahomecare.org/pages/medical-community-survey-on-effects-of-competitive-bidding" target="_blank">aahomecare.org/CareSurvey</a>; suppliers may also share an <a href="https://aahomecare.wufoo.com/forms/q3l9dno0ats1fe/?utm_source=Members-Only+Updates&utm_campaign=c960c57b13-WiW_July_27_2016&utm_medium=email&utm_term=0_b7e8527839-c960c57b13-97426517" target="_blank">online version of the survey</a> with case managers.<br />
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For more information on the survey, contact Ashley Plauché, manager of government relations at AAHomecare, at <a href="http://ashleyp@aahomecare.org./">ashleyp@aahomecare.org.</a>AAHomecarehttp://www.blogger.com/profile/12404878973597039092noreply@blogger.com0tag:blogger.com,1999:blog-5703736551017069324.post-14873532834540632312016-07-29T09:00:00.000-04:002016-07-29T09:00:08.736-04:00Let Us Know How You're Doing in This Challenging Environment for HME<i>By Michael Nicol, senior director of membership services</i><br />(excerpt from Wednesday in Washington, July 27)<br />
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Faced with the very real and serious consequences of this latest round of reimbursement cuts, and the frustration of having multiple unanimously approved bills come up centimeters short of the goal line as the clock ran out, you are understandably numb. No one could blame you for wanting nothing more than to retreat, lick your wounds, and consider waving the white flag and making a graceful exit. <br />
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Don't do it. You may be closer than you think.<br />
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<b><i>Our War of Attrition</i></b><br />
Skeptical as you may be right now, you can still outlast those who seek to wear this industry down with untenable reimbursement policies, onerous and redundant auditing requirements, and "one size fits all" approaches to your highly specialized and value-added industry by being methodical, resolute, and doggedly determined. <br />
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Since I began my tenure at AAHomecare, I've gained a genuine appreciation and respect for our member companies. You have been chasing a fairer, more stable, and more equitable business climate - some of you for decades - and you've somehow managed to hold off the forces that threaten the very existence of your business, even as the other side held all the cards. While we might not want to go so far as to characterize these forces as our "enemies"--there is most certainly a life-or-death, sink-or-swim battle going on here for many of you, and one of the weapons we can collectively use to win it is education.<br />
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That's exactly why I and my colleagues have begun reaching out directly to you to solicit your personal stories of how the most recent set of reimbursement cuts for rural providers is going to (or already has) negatively impacted your business and your ability to serve patients. This takes many forms. Patients losing access, independence, vital services, and compliance- and outcomes-enhancing product education...employees losing their jobs and communities their neighborhood businesses...the list goes on. And ironically, all of this may ultimately cost the health care system itself so much more money than what will purportedly be "saved" through these sweeping, short-sighted reimbursement cuts and related policies. <br />
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<b><span style="color: red;">We Need to Hear from You! </span></b><br />
You are the people best equipped to specifically articulate the real-world impact of these cuts on our industry and the people it serves. And we are your association. I ask you to take some time to verbalize and share your stories with us, so that we may make the most compelling case possible with our Congressional champions as we mobilize once more in the coming weeks to package and pass a legislative solution in September. <br />
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If your company is experiencing difficult business decisions, not accepting new patients, or making other changes based on the January 1 and July 1 cuts, please let us know. Send these narratives to my colleague Tilly Gambill at <a href="mailto:tillyg@aahomecare.org">tillyg@aahomecare.org</a>, or feel free to reach out to me, my contact info is below.<br />
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<i>Michael Nicol is the Senior Director of Membership Services for AAHomecare. He is available to help members become better connected with the Association through Councils, member programs and benefits, and answer general questions. Michael also accepts recommendations on potential new members. He can be reached at 202-372-0749 or <a href="mailto:michaeln@aahomecare.org">michaeln@aahomecare.org</a>. </i>AAHomecarehttp://www.blogger.com/profile/12404878973597039092noreply@blogger.com0