MassHealth Implementing 10% Rate Increase for DME Claims

Funding comes after HOMES and AAHomecare push Massachusetts to provide relief via the American Rescue Plan Act and sets the stage to notify Medicaid officials in other states.

• By David Kopf
• Jul 22, 2021

Leveraging relief provided by the American Rescue Plan Act, the Massachusetts Medicaid program, MassHealth, will implement a 10 percent rate increase for DME claims with dates of service effective July 1, the American Association for Homecare reported this week.

The relief applies a 10 percent increase for all DME and augmentative and alternative communications codes, as well as a 50 percent increase for labor code K0739, which covers repair or non-routine service requiring a skilled technician for DME other than oxygen equipment.

“This is a big win when we needed it most,” said Jason Morin, president & CEO of the Home Medical Equipment and Services Association of New England (HOMES). “Between the pandemic impacts and the recent respiratory recall, providers are reeling and struggling to find ways to continue to absorb these rising costs. This action provides much-needed direct relief to the providers of Massachusetts and also shows us that the state’s Medicaid leadership is listening.”

In June, HOMES requested that DME suppliers receive a share of the healthcare-focused relief funds granted to Massachusetts through the American Rescue Plan Act, a federal relief package that provides relief funds at the state and local levels. The request, along with HOMES’ efforts to build relationships with MassHealth leaders and other healthcare officials, should help MassHealth suppliers contend with the higher product and operational costs related to the pandemic.

Morin added that Laura Williard, vice president of payer relations for the American Association for Homecare, and David Chandler, senior director of payer relations for AAHomecare, were “instrumental” in developing “materials and resources and provide a national perspective in many of our meetings.”

AAHomecare worked with state and regional association leaders to develop sample letters to request that DME suppliers receive a share of the $195 billion allocated to states to mitigate COVID-19’s fiscal impact on healthcare providers as well as a temporary 10 percent increase in federal matching funds.

“DME suppliers deserve a share of this support, and we’re committed to helping state leaders make the strongest possible case for being included in state-directed relief,” AAHomecare’s Williard said. “Now that the first state has explicitly approved our industry to share in this relief, we have an opportunity to let Medicaid officials in other states know about the precedent Massachusetts has set.”

Learn More: 

• Massachusetts HHS Announcement 
• American Rescue Plan Fiscal Relief Summary 
• HCBS Matching Funds Summary 
• Sample State Funding Request Letter.