Note: the following is republished with permission from a Sept. 17 alert from the Great Lakes Home Medical Services Association.

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As previously reported, effective October 1, 2019, the Indiana Health Coverage Programs (IHCP) will implement reimbursement and policy changes for HME that were announced in the 9/03/19 ICHP bulletin BR201936. According to the bulletin, the Indiana fee schedule will be priced at the “lowest non-zero Medicare rate” and manual pricing methods will change. Due to the significant and sudden impact of these changes, AAHomecare and the Great Lakes association are collaborating on a response to FSSA from the HME community.  
 
Indiana HME stakeholders met with mid-level leadership at FSSA by phone on Sept. 12 and requested a delay for further evaluation and partnership between FSSA and providers to ensure rates are analyzed and established at a level that will protect patients’ access to care. We were informed that they are already making changes to their systems and a delay was not possible. We submitted many questions to FSSA in a letter regarding the changes and they were unable to provide adequate responses in the short timeframe prior to 10/01/19. As a result, we have initiated a quick campaign engaging FSSA and CMS Regional Office and we urge HME providers doing business with Indiana Medicaid to get involved.
 
What is being done:

• A request was emailed on 9/11/19 to CMS Regional Office on behalf of AAHomecare and Great Lakes requesting the following:
• Deny/delay SPA 19-003;
• Request FSSA to conduct a thorough analysis of utilization data by county and by DME provider to obtain an accurate assessment of access to DME equipment and supplies for Indiana beneficiaries;
• Request FSSA to identify and quantify the extent to which beneficiaries are unable to secure DME equipment and supplies; and
• Request to address if the issue of how a decrease of the FFS rates for DME would affect Indiana managed care plan-funded rates and discuss with the plans.
• VGM e-mailed a letter 9/15/19 to FSSA Director Taylor and Deputy Director Hatchett sharing concerns; Director Taylor responded that they will review and follow-up.
• Great Lakes will send letter to FSSA leadership with the Indiana Medicaid Cures Issue Brief to reinforce our concerns.

 Call to Action! What you can do:

• Send a letter to CMS Regional Office supporting the “ask” above from AAHomecare and Great Lakes in protest of SPA 19-003. A sample letter is provided. Send to John Hammarlund, Director, Region 5 via email at ROCHIfm@cms.hhs.gov and mail a hard copy to the Chicago address in the letter.
• Contact your state representative and senator to share concerns - to find your legislator, click here.
•  Use the Issue Brief for talking points;
• Share the most recent Supplier Tracking Chart from AAHomecare based on CMS data that shows Indiana has about 38% few HME suppliers with Medicare numbers from Nov. 2010 to Apr. 2019. The HME provider infrastructure is fragile and dwindling already raising concern about access.
• Inform your Medicaid customers and social workers! Describe the impact of the Medicaid proposal and ask them to contact their legislator/senator to express concern for the risk to their care and choice.

Thank you to AAHomecare and VGM for their quick assistance to engage with Great Lakes on this critical issue for Indiana providers. We will continue to keep members updated on these developments. If you have any questions or feedback for Great Lakes, please email Kam Yuricich at the office.