Letter from W.Va. Lawmakers to CMS Details Access Problems

Providers work with Congressional Representatives from state to emphasize that patients are encountering access issues.

After CMS’s proposed ESRD and DMEPOS rule failed to resolve the higher costs and low reimbursement plaguing rural providers, a group of West Virginia lawmakers sent a letter to CMS Administrator Seema Verma asking for the agency to address the issue.

Highlighting that the Mountain State has lost 38 percent of its HME providers over the last two years, the letter restated concerns over difficulties facing rural providers that the Congressional delegation says it had previously communicated to CMS.

It also noted that areas CMS designates as “rural” for DMEPOS do not match the classification for rural clinics and critical access hospitals (CAHs) in the state. 

“This creates more issues for keeping the cost of providing care across the continuum low due to lack of access,” the letter reads. “When the CAH cannot timely discharge a patient due to limited or no access to home oxygen or other medical equipment it creates a hardship on the family and adds more expense on the Medicare systems.”

AAHomecare noted that Best Home Medical President and Owner Regina Gillispie, a longtime industry advocate, led the effort to get the West Virginia lawmakers to raise the issue. Gillispie also credited Jeanette Lancaster of Mon Home Healthcare and Kevin Milam of The Billing Center for engaging West Virginia lawmakers during May’s Washington Legislative Conference.

Gillespie connected Congressional offices with West Virginia Medicaid officials, who affirmed that patients and hospital discharge planners are being served by a sharply declining number of providers. She also emphasized the rural classification issue to the state Congressional delegation.

“The information about the differences in rural classification made a strong impression on the Congressional offices,” Gillispie said. “They know those areas well, and they understand how challenging — and critical — it is to deliver quality care outside of metropolitan areas.”

To read the full letter, visit bit.ly/2Ohuv2K.

About the Author

David Kopf is the Publisher and Executive Editor of HME Business and DME Pharmacy magazines. Follow him on Twitter at @postacutenews.

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