WASHINGTON, DC – Last week the DME MACs announced that the Documentation Requirements section of the Local Coverage Determinations (LCDs) will be revised. Currently, the Documentation Requirements section has a “Policy Specific Documentation Requirements” subsection which includes requirements that are specific to each individual LCD. DME MACs started including this subsection in 2011 to help suppliers with meeting all the payment rules associated with the LCD. However, DME MACs will no longer be including that subsection due to the administrative burden associated with updating the section. You can find the announcement here.
States & AAHomecare Explore Approaches to Address Competitive Bidding Pricing for Medicaid
WASHINGTON, DC – AAHomecare’s State Leaders Council, comprised of state association leadership from across the country, formed a Work Group to collaboratively develop strategies and coordinate resources for tackling the provision in recent CURES legislation that limits the federal portion of Medicaid spending to competitive bidding prices for DMEPOS starting in 2018.
The Work Group is investigating what level of flexibility states have in Medicaid rate-setting under the new legislation, and will develop approaches to educate state Medicaid Directors about their options under the new law. The messaging crafted by the Work Group will both clarify the level of autonomy in determining their rates and reinforce the value of HME as a cost-effective partner in health care that provides better clinical outcomes.
“We’re excited to expand the focus of AAHomecare’s partnership with our local HME associations to tackle increasing state issues facing our members as a result of the changes mandated in the CURES Act that affect Medicaid reimbursement,” says Kam Yuricich, who chairs the Work Group and the State Leaders Council in addition to being the Executive Director for OAMES and Great Lakes Home Medical Services Association. “This is truly when strong coordinated team work matters for our members.”
As AAHomecare supports the Work Group initiative, it is engaging the National Association for Medicaid Directors about the CURES-mandated provision, how it affects Medicaid programs, and what states can do to overcome shortages in their federal portion of the Medicaid budget. AAHomecare will also work with the new Administration and key committees of jurisdiction to get clarity on how this program will work for the Medicaid programs and any potential impact on Medicaid Managed Care plans.