WASHINGTON, DC – AAHomecare officials thanked dozens of HME providers who have reached out to share their stories about the disruption that bidding-derived rate cuts is causing in rural communities and other non-bid areas. These stories helped generate media interest and understanding of the impact of these cuts, which ultimately gives us more visibility and credibility on Capitol Hill. Examples of coverage this week include:
• As Congress Returns, Homecare Industry Says Urgent Action Needed on Medicare Reimbursement – InsideSources (Aug. 31)
• Congress Should Stand up for Small Businesses and Seniors on Medicare – The Hill (Aug. 30)
• Rural Americans on Medicare Will Continue to Receive Inadequate Care Unless Congress Acts – Morning Consult (Aug. 29)
AAHomecare also learned of an Illinois-based HME provider with a history stretching back 170 years that is now in the process of closing its doors; this is a business that has seen the Depression, two World Wars, and 33 different U.S. Presidents take office, but couldn’t survive this climate for HME reimbursement.
AAHomecare plans to continue its efforts to spark media interest in the wake of these rate cuts that are not only affecting Medicare rates for rural and non-bid providers, but are also impacting TRICARE reimbursements nationwide. They are also using these stories on Capitol Hill with offices that are especially interested in seeing the real world implications of these cuts.
Please send your stories to Tilly Gambill, firstname.lastname@example.org. If you do not feel comfortable with having stories shared in the media, please let Tilly know, and your story will only be shared in the materials going to Congressional staff as noted above.
AAHomecare Comments on Appeals Process
WASHINGTON, DC – On Monday, AAHomecare submitted comments to HHS’ proposal to make improvements to the Medicare appeals process. In the comments, AAHomecare agreed that reforms to the Medicare appeals process are essential to ensuring that appeals are fair and serve the interests of providers and beneficiaries.
However, the reforms in the proposal do not address CMS audit and appeals policies that are the source of the current backlog. AAHomecare provided the following recommendations to HHS:
1) Provide an opportunity for a telephone hearing in place of the on the record Qualified Independent Contractor (QIC) level of appeal.
2) Waive the one year claims filing limit for DMEPOS claims on appeal.
3) Require claim processing contractors and appeal adjudicators to give precedent to DMEPOS claims and appeals determinations for the same item and same beneficiary.
4) Prohibit contractors from repeatedly auditing claims for the same item and same beneficiary.
5) Implement an effective prior authorization procedure for DME, especially for respiratory and mobility devices.
Click Here to read AAHomecare’s comments.