Funding


News Feature

HME’s Bottom Line Success

AAHomecare advocacy efforts have resulted in policy and regulatory wins that have driven more than $2 billion back to HME providers’ budgets. How does the association plan to build on those wins?

HHS Extends COVID-19 PHE

The public health emergency, as well as the regulatory relaxations associated with it, will continue for another 90 days.

Fla., Okla., N.Y. Associations Seek Support on Legislation

The legislative efforts seek to protect state reimbursement rates and patient access for HME by blocking moves to privatize state Medicaid programs.

Medicare Sequestration Bill Now Law

The moratorium on the 2% Medicare sequestration reimbursement cut now lasts until Dec. 31.

The Return of Medicare Claims Audits

Several months ago CMS threatened it would resume its claims audits. Now that is happening and audit expert Wayne van Halem provides the details on what’s happening and what providers need to know.

CMS Temporarily Holds Applying Sequester Cuts

While the extended moratorium on the 2% cuts officially ends April 1, CMS will continue holding off on applying them while Congress finishes related legislative action.

Senate Votes to Extend Pause on Sequester Cuts

The compromise legislation extends the moratorium until the end of the year. It now moves to the House for passage and then President Biden's office to be signed into law.

AAHomecare: O2 Rates Will Bolster Reimbursement for Years to Come

Besides adding $650 million in reimbursements for oxygen suppliers over the next 10 years, the recent win should pay other dividends industry advocates say.

CMS Publishes New Oxygen Fee Schedule

Starting April 1, the new rates don’t apply budget neutrality, resulting in an increase in reimbursement for oxygen products nationwide.

Billing

Prior Authorization Success

Why outsourcing your HME prior authorization service is important in 2021?



Legal Analysis

Modifications to Stark and the Anti-Kickback Statute

In transitioning from fee-for-service payment to value-based care, the new model has run up against the federal physician self-referral law and the federal anti-kickback statute, which have both seen modifications as a result. There is a lot that providers need to understand, so here's a deep dive into the topic.

Advocates Push to Extend Pause on Sequestration Cuts

With Medicare’s moratorium set to expire soon, AAHomecare and other advocates are reaching out to lawmakers to extend the suspension of the cuts until the end of 2021.

CMS Updates DMEPOS Fee Schedule

Citing errors in the December 2020 schedule, this new release includes adjustments to more than 900 HCPCS codes.

NEMEP Taking Registrations for Virtual Conference

March 23-25 event for N.Y. and N.J. providers offers a variety of conference sessions across multiple tracks and includes CEU opportunities as well.

lungs

Breathe Easy?

COVID-19 has strained America’s oxygen infrastructure like nothing before. What factors are impacting supply and demand, and how are stakeholders responding? What other factors are impacting the oxygen market at the same time?

New Prochant Site Emphasizes Online Resources 

Company that offers reimbursement, financial and revenue cycle management solutions for HME providers and pharmacies rolls out a new site designed to help them find solutions faster.

Blackburn Aims to Protect Tennessee's Medicaid Block Grant

After CMS recently approved block grants for Medicaid, the Biden administration made announcements that could jeopardize the waivers. Measure introduced by Sen. Blackburn would protect TennCare's recently acquired block grant waiver.

Industry Joins Effort to Extend Medicare Rate Relief

As Congress negotiates COVID-19 relief, AAHomecare backs push urging Congressional leaders to include H.R. 315 in their legislation, which would extend the Medicare sequester moratorium through the PHE.

PRF Payments Applicable to Lost Revenue Based on Formal Budgets

The latest HRSA guidance marks the fourth revision to lost revenue calculations for PRF reporting. How has it evolved and what do providers need to know?

Editor's Note

The Industry That Could

HME providers have demonstrated their crucial role in American healthcare during COVID-19.

Podcast: COVID-19 Lessons From a Policies and Procedures POV