Funding


Next Round of Audit Key Submissions Starts April 17

Tool helps industry collect audit data in order to help make its case for reforming CMS’s audit program; now easier for Brightree users.

N.Y. Incontinence Rate Change Pushed to May

Originally slated to go into effect April 3, implementation of rate cuts will go into effect May 17.

respiratory audits under a microscope

Business Solutions

Respiratory Audits: Under the Microscope

As the new RAC comes online, and as the 2017 HHS OIG Workplan is in effect, what can respiratory providers expect in terms of audits, and how should they respond?

Providers Sound Off of CURES Act Call

HME stakeholders share their stories of how bid expansion has impacted their businesses and patients on CMS call; providers can still submit feedback via email.

Respiratory Industry Fights CPAP Bundling

Providers, AAHomecare, VGM, vendors, other stakeholders form unified front against CMS’s plan for bundled pricing for CPAPs and supplies.

CMS Slates Second Prior Auth. Special ODF

Second Open Door Forum will take place on March 21 and provides forum for additional discussion on prior authorization for K0856 and K0861.

Verma Takes Helm of CMS

After Senate votes 55-43 to approve Seema Verma as CMS Administrator, she takes first joint action with HHS Secretary Price.

CMS Slates Prior Authorization Call

March 16 Open Door Forum will focus on prior authorization process for power wheelchairs.

NY Providers Reduce Incontinence Cuts

NEMEP, AAHomecare advocacy effort leads N.Y. Dept. of Health to limit its reimbursement cuts.

AAHomecare Asks HHS to Repeal Full Bid Expansion Rates

Letter from association asks HHS Secretary Tom Price to set rates for rural/non-bid areas at the 50-50, phase-in rates.



Provider Strategy

The RAC is BACK

New changes to the RAC program will start this month. What does that mean for providers?

Leitten Study: HME Saves Medicare Significant Sums

Annual savings to Medicare program range from $23 to $41 for every dollar invested in HME; translates to millions annually.

Health Spending to Grow 5.6% Over 2016-2025

Health expenditures will grow faster than GDP and represent an increasingly larger share of GDP.

CMS Instructs DME MACs on CURES Reimbursement

CMS outlines how DME MAC contractors are to begin implementing retroactive reimbursement per the law; process should begin in May.

AAHomecare: TRICARE Must Fall in Line with CURES Act

Association calls on military insurance program to reprocess 2H 2016 HME claims per CURES-mandated reimbursement adjustments.

CMS Consolidates All Bid Areas Into Single Round

Agency moves to merge Rounds One and Two, as well the mail order competition, into a single competitive bid it calls Round 2019.

TRICARE Awards Eastern Contract to Humana

Humana issues ‘welcome’ statement to providers; military insurance program moving to two regions this year.

States, AAHomecare Study Response to Bid Pricing for Medicaid

Component of recently approved CURES Act limits Federal portion of Medicaid spending to competitive bidding prices for affected DME items, starting 2018.

Q4 Audit Survey Starts Jan. 16

HME Audit Key program urges providers to submit their audit data for Q4 2016; program helps industry better understand audits and advocate reforms.

AAHomecare Convenes Hi Tech Work Group

Group will examine how new technologies for creating new care and reimbursement models.

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