AAHomecare Payer Relations COVID-19 State and Payer Response:

AAHomecare has prepared a list of policy recommendations for state Medicaid agencies to adopt amid the current COVID-19 crisis.  Access to Home Medical Equipment (HME) is more important now than ever and we need to remove as many barriers to care as possible.  AAHomecare met with the National Association of Medicaid Directors (NAMD) to collaborate on these policy changes and guidance for messaging this list nation-wide.  We are also reaching out to top commercial payers with similar recommendations to ensure providers have limited cash flow interruption.  As this situation remains fluid we will continue to monitor and make additional recommendations as necessary.  Recommendations to state Medicaid agencies are as follows:

1.    Provide coverage for short term oxygen for beneficiaries with acute conditions to ease hospital overflow issues.
2.    Allow for coverage and reimburse equipment, supplies, and services provided to patients with a confirmed COVID-19 diagnosis. 
3.    Waive all prior authorization and re-authorization requirements for all DMEPOS items and repairs.  
4.    Waive prior authorization requirements for exceeding quantity limitations on gloves, incontinence, urological, ostomy, oxygen, suction, ventilators, enteral, and wound care supplies.
5.    Reduce burdensome paperwork requirements by allowing the standard prescription documenting any required test results to meet medical policy documentation requirements for a 270-day period.
6.    Waive any face to face requirements if prescriber couldn’t or wouldn’t do an office visit and allow telehealth visits to meet requirements while waiving the video component.  Recent federal guidance to reduce barriers to telehealth services are a step in the right direction. https://www.medicaid.gov/medicaid/benefits/downloads/medicaid-telehealth-services.pdf
7.    Allow an extension of the expiration date of written orders for an additional nine months from the date orders currently expire, for recurring medical supply orders and on-going DME rental claims.
8.    Allow in home sleep testing through an independent testing facility (IDTF) to qualify beneficiaries for PAP devices.  
9.    Allow additional oxygen, PAP, ventilator, and suction supplies for patients who become sick or diagnosed with COVID-19.  
10.    Waive signature requirements for proof of delivery on HME items; including allowance of text, email, photographic, or confirmed shipment receipt from third-party carrier evidence to validate proof of delivery during COVID-19 crisis.
11.    Waive all place of service edits that would normally result in a claim denial for HME while a patient is placed in an in-patient facility related to COVID-19.
12.    Add coverage without prior authorization for code A4928 (surgical masks, per 20).
13.    Allow minimum of 180-days timely filing for Medicaid and Medicaid managed care plans.
14.    Require Medicaid and Medicaid MCO plans suspend all audits to allow DMEPOS suppliers to focus on their emergency activities by: 
A.    Exempting providers from future audits on patients with COVID-19.  
B.    Discontinue sending new Audit/ADR requests and extend existing audits due dates by 180-days.
C.    Extending appeal deadlines by 180-days past the current appeal requirements.
15.    Allow any requirements for clinician and/or assistive technology professional in-person engagement for complex rehab wheelchairs and accessories to be met through the use of remote technology.   
16.    Allow that DMEPOS suppliers be categorized as “essential services” to allow delivery to quarantined areas.
17.    Allow Prescribers not currently enrolled in Medicaid programs to order DMEPOS.  
18.    Require a temporary moratorium on reductions in fee schedules for DMEPOS providers to preserve access to care. 
19.    It is imperative that provider cashflow is not interrupted to ensure providers are able to continue servicing patients in this time of need.  Claims adjudication and processing must occur on normal schedule.

AAHomecare has drafted a letter for state Medicaid agencies with policy recommendations amid the COVID-19 crisis.

AAHomecare has drafted a letter for Commercial Payers amid the COVID-19 crisis.
 

Recommendations Updated 3/26/20