CMS Revs Up CURES-Mandated Medicaid Revisions

CMS will send letters to state Medicaid Directors, host a special call, and is creating reporting structure to ensure compliance.

The Centers for Medicare and Medicaid Services is beginning the process of implementing Medicaid-related provisions that were part of the CURES Act, which was passed in December 2016.

The CURES Act included provisions to give relief to providers and patients affected by the national expansion of competitive bidding to non-bid areas. However, one pay-for of the CURES Act was an acceleration of the plan to limit the Federal matching on Medicaid reimbursement rates for HME to the Medicare fee-for-service payment rates, including for items impacted by competitive bidding-derived rates. Rather than apply those rates in January 2019, the application would be ramped up by one year to Jan. 1, 2018. 

The American Association for Homecare has been meeting with CMS during 2017, and has worked with state Medicaid programs, state associations, stakeholder groups, and legal counsel during the year to ensure that the Medicaid programs understand their rights in managing their program and their responsibilities to ensure access to care under these new requirements.

At the most recent meeting, AAHomecare reports it received additional information related to a notice from CMS in the Federal Register (http://bit.ly/2zTAtTY) that says Medicaid agencies will need to show they are complying with this regulation by annually reporting their claim payments for specific HCPCS codes which include K and E codes and some A codes. 

AAHomecare also said that CMS will send a letter to State Medicaid Directors that provides additional guidance, and will host a State Operational and Technical Assistance call on Dec. 7, in which the association will participate.

“State Medicaid programs do not have to set their rates at a Medicare allowable,” a statement from AAHomcare read. “States will continue to have the flexibility to set their own rates to ensure access to care.  However, given the fact that the Federal match is being reduced to reflect Medicare rates, we expect many states will feel compelled to lower fee schedules accordingly. AAHomecare will provide support to state/regional association leaders and other stakeholders in advocating for sustainable Medicaid reimbursement rates under these new program requirements.

The association encourage providers seeking more information to read its issue summary on the CURES Medicaid requirements (http://bit.ly/2zTSHos), or contact Laura Williard, vice president of payer relations, at LauraW@aahomecare.org for more information.


About the Author

David Kopf is the Editor of HME Business.

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