Industry Works to Gain More Ground With ARPA Relief

After last week’s Medicaid gains in Massachusetts, AAHomecare, state associations and stakeholders pursue additional relief for HME providers in more states via the American Rescue Plan Act.

• By David Kopf
• Jul 29, 2021

After using the 2021 American Rescue Plan Act (ARPA) to notch a Medicaid reimbursement increase in Massachusetts, the American Association for Homecare’s payer relations team has reported it is with leaders at state and regional associations to obtain more of the relief funds for providers in other states.

Last week, the Massachusetts Medicaid program, MassHealth, announced it would use ARPA funds to implement a 10 percent rate increase for DME claims with dates of service effective July 1.

There are two ways that ARPA can benefit healthcare providers:

• It provides $195 billion to states to mitigate economic harm related to the pandemic.
• The legislation also increases the federal medical assistance percentage (FMAP) for certain home and community-based services (HBCS) by 10 percent. The 

AAHomecare developed materials for HME leaders in individual states to explain these programs, as well as sample language to request that Medicaid authorities and other government officials include HME in these services. 

States have flexibility in how they apply their share of the $195 billion grant to mitigate the impacts of the pandemic. The sample request letters AAHomecare developed with state leaders suggest a one-time payment to HME providers of 10 percent of their DMEPOS Medicaid billing for dates of service between March 6, 2020, and April 30, 2021. 

For requests related to the FMAP-related relief funds, the materials highlighted that states could utilize the additional funding for a variety of purposes, such as broad-based relief for all HME suppliers based on their Medicaid billings; coverage for HME suppliers sending certified or registered therapists into the home; and coverage for remote patient monitoring, telehealth, and PAP compliance tracking.

“With such extensive relief potentially available, it’s been critically important to make sure that state leaders are equipped to make an effective case for garnering a share for HME suppliers,” said Laura Williard, vice president of payer relations for AAHomecare. “I appreciate the terrific support from the suppliers and association executives who have been a part of developing our approach and sample request language for states to use.”

Williard and David Chandler, senior director of payer relations, have worked directly with state association leaders and report they know of 26 states that have requested these funds.

“Additional relief is critically needed by HME suppliers who are dealing with increased costs thanks to staffing shortages and higher product prices, especially for PPE,” said Barb Stockert, executive director for the Pacific Association for Medical Equipment Services (PAMES) and for the Big Sky Association of Medical Equipment Suppliers. “Laura and David have done an amazing job educating state leaders about the process and helping us put together request letters to governors, state legislators, and other state healthcare officials.”

PAMES and Big Sky ultimately submitted relief requests for HME for both the $195 billion tranche of funds and the FMAP funding for Idaho, Montana, Oregon, Washington, and Wyoming.

“State association leaders have built solid relationships with Medicaid officials and strengthened awareness of the role that high-quality HME plays in protecting seniors and vulnerable patient populations in their states,” adds Williard. “It’s heartening to see that recognition pay off in Massachusetts. Now we need to make sure governors, state legislators, and health officials who are distributing these funds are aware of the important precedent that’s been set there and bring home more relief for HME.”