The American Association for Homecare (AAHomecare) is ramping up its advocacy efforts regarding proper reimbursement for and beneficiary access to continuous glucose monitors (CGMs) and noninvasive ventilators (NIVs).
In an Oct. 2 news announcement, the association said it has “expanded the scope of its relationship with legal and public policy stalwart Foley Hoag.”
“AAHomecare began working in earnest in July 2021 to prevent Medicare Advantage payers from applying overly restrictive coverage criteria for NIVs,” the association said in the news announcement. “Our efforts have included directly engaging CMS [Centers for Medicare & Medicaid Services] on the issue, enlisting members of Congress to help make our case, outreach to medical directors at major payers, and generating media coverage. In many cases, these efforts have been supported by the ALS Association and the leading respiratory physician group CHEST [American College of Chest Physicians].”
AAHomecare is also “working with state-level stakeholders” to retain Medicaid coverage for CGMs under the DME benefit, “rather than as a product solely provided through the pharmacy channel.”
“AAHomecare has great credibility in Congress and HHS [U.S. Department of Health & Human Services] regulatory agencies such as CMS,” said Thomas Barker, partner and co-chair of Foley Hoag’s health-care department. “As the American health-care system evolves to new payment and regulatory models, it is crucial that AAHomecare members have representation that will protect their interests in this evolution. I am looking forward to working with the organization and its members on this engagement in the months and years to come.”
“Protecting patient access to the full range of clinically proven products and services is critically important to HME [home medical equipment] providers and the millions of patients and caregivers we collectively serve,” said Tom Ryan, AAHomecare’s president/CEO. “Wherever AAHomecare sees the connection between providers and patients threatened or diminished in any meaningful way, we’re going to make that a priority.
“Foley Hoag’s expertise in Medicare and Medicaid policy is already helping us sharpen our arguments by identifying established laws and regulations that support our advocacy goals. In addition, their relationships with leaders at CMS and in Congress will help us reach the most important decision-makers on these issues.”
AAHomecare is collecting accounts of how CGM and NIV policy changes have impacted Medicare beneficiaries, their families and caregivers. These accounts will be used to educate payers and government agencies on CGM and NIV issues.
Patients and families can upload their CGM stories and NIV stories in writing or via video to AAHomecare portals.