Continuing to ramp up an initiative it began two years ago, the American Association for Homecare is continuing to increase its emphasis on state-level advocacy this year, and it’s looking specifically at CRT.
“State-level advocacy will remain a major focus for the Association in 2019, as we continue our work to stabilize Medicaid and MCO reimbursement rates and maintain strong beneficiary access and choice for HME,” said AAHomecare President and CEO Tom Ryan in a recent statement released this week. “We plan to build on our successes by devoting additional resources to our payer relations program, while also opening up a front to strengthen access to CRT.”
During 2018, an AAHomecare effort spearheaded by Laura Williard, vice president of payer relations for AAHomecare, coordinated with state and regional HME association leaders and other stakeholders to alert and educate state Medicaid officials that they had flexibility in implementing provisions of the CURES Act. This stopped or limited reimbursement cuts in 29 states.
Going into 2019, the association’s next state-level initiative will be to advocate that complex rehab technology should be a separate benefit at the state funding level. This will come through advancing separate benefit status legislation in the states. This will protect vulnerable CRT patients by ensuring these devices aren’t subject to rate cuts by state Medicaid agencies and MCOs.
“Highly specialized products like CRT need regulatory requirements that recognize the unique nature of both the equipment and the patients who use them,” explained AAHomecare chairman Steve Ackerman, who is also CEO of Silver Spring, Md.-headquartered HME business Spectrum Medical Inc. “State-level separate benefit legislation will ultimately allow more Medicaid beneficiaries and their caregivers to take advantage of these life-changing products.”
AAHomecare has brought on Bridge Public Affairs, a firm with extensive state-level advocacy experience, to assist in this effort. The Bridge team will be led by John Goetz, former director of government affairs for Permobil. Goetz will wield his knowledge of mobility issues, contacts with state legislators and regulators, and past experience working for Tennessee’s Medicaid agency.
“State Medicaid coverage and reimbursement issues are increasing nationwide, especially for complex rehab,” Goetz noted. “It is important that the HME industry take steps to guarantee those that we serve get the equipment they need and deserve. These efforts will benefit the entire industry and will build momentum for change nationally.”
“Our expanded commitment to payer relations has paid major dividends in protecting HME from Medicaid reimbursement cuts in dozens of states,” Ryan added. “As more patients are served by Medicaid, MCOs, and Medicare Advantage, AAHomecare’s payer relations efforts will become increasingly important in protecting HME interests.