Funding


AAHomecare Presses Anthem on Rates

After insurer cut reimbursement in July despite COVID-19 costs, HME association highlighted the disparity between Anthem’s funding and Medicare’s rates for HME during the health emergency.

UHC Fixes Uninsured Patient Funding Problem

A system error that was rejecting DME claims for uninsured patients under the CARES Act has been addressed.

HSS Pushes Provider Relief Application to Sept. 13

Agency extends the application deadline for Phase 2 General Distribution after expanding eligibility for the funds.

Joining the Fight to Protect Manual CRT Users

NCART's Don Clayback joins the HMEB Podcast to explain how providers can quickly and easily help protect funding for manual CRT accessories by convincing their lawmakers to sign a letter to CMS before the deadline.

Funding

Knowing the Latest Relief Details

More specifics have emerged on expanded Phase 2 of CARES provider relief. Make sure you know the options available to you.

Observation Deck

Return of the Audits

The news that CMS planned to resume audits by Aug. 3 took many by surprise. Then CMS said it would resume audits in a phased approach. What are the details and what can providers expect?

AAHomecare Rounds up Industry Issues in Play

While COVID-19 is at the fore of the industry’s mind, the next four months offer the industry to notch some policy wins on non-bid area rates, taxes on Cares relief, and CRT accessories

HHS Pushes Deadline for Medicaid/CHIP Relief to Aug. 28

Agency extends application deadline for Medicaid providers and plans to reopen portal to certain Medicare providers from Aug. 10 until Aug. 28.

Prochant Expands Into Infusion Pharmacy 

The company pairs a new service line with the hire of a new VP of Business Development and Pharmacy Reimbursement Manager.

Report: COVID-19 Will Push Long-Term Telehealth Use in Medicare

Research effort shows telehealth use has skyrocketed more than 12,000% from before the public health emergency to the end of April, and Medicare Advantage is seeing a lot of that growth.



HHS’s COVID-19 PHE Extension Brings Continued Relief

The 90-day extension means continued CARES Act relief, relaxed regulations from CMS and state Medicaid programs, as well as from other payers.

NEMEP Unveils New Board of Directors & Virtual Meeting Agenda

The new event takes place Sept. 28-Oct.2 and will be provided free of charge for members and non-members. The new board includes varied members from across the region.

PAMS Secures COVID-19 Hazard Pay Eligibility for HMEs

After outreach from the association, the state includes HME providers in a special frontline health worker grant program that increases workers’ hourly wages for 10 weeks.

Two Key Industry Efforts: Round 2021 Delay and AAHomecare Ambassadors

Tom Ryan of American Association for Homecare joins the HMEB podcast to discuss the current push to delay Round 2021 and the special Ambassador project to get more providers involved in the association.

Medicare Advantage Use Continued to Rise in 2019

Between Q4 2018 and Q4 2019, Medicare Advantage use grew by 4%, according to data released by HME sales platform PlayMaker Health. The update also covers Home Health and Hospice.

CMS: Audits Won’t Fully Resume on Aug. 3

After AAHomecare shared industry concerns over audit resumption, CMS provided a more nuanced and detailed description of how the audit programs will recommence.

House Sign-on Letter Calls for Bid Delay

HME providers have until July 29 to secure signatures on Congressional letter urging HHS and CMS to delay Round 2021 for at least a year.

CMS to Resume Medicare Audits, Prior Authorization on Aug. 3

Postponed since March 30, TRP, SMRC and RAC audits will restart next month, as will prior authorization for PMDs and support surfaces.

Anthem Won’t Rescind or Delay HME Cuts

Despite efforts from AAHomecare, Anthem and subsidiary Amerigroup have doubled down on cuts to HME rates that go as high as 60 percent.

Applications for Medicaid/CHIP Provider Relief Due July 20

The run-up to the deadline continues while AAHomecare notes that HHS is aware policies could potentially penalize Medicaid-focused suppliers who also served Medicare beneficiaries.

HME Business Podcast