Rural and non-bid area oxygen suppliers need relief from “double dip” cuts in the 2017 Medicare fee schedule for stationary oxygen, which result in rates for rural and other non-bid area suppliers that are lower than the competitive bidding rates for this product category in many CBAs.  These new rates stem from the application of a 2006 budget neutrality offset balancing increased utilization for oxygen generating portable equipment with lower reimbursement for stationary equipment. AAHomecare...

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“Today rural America oxygen payments are lower than urban competitive bid payments - that’s egregious,” president and CEO of AAHomecare, Tom Ryan, said during his interview with DC’s News Channel8. “CMS has used an old payment methodology and applied it to the new payment methodology, and essentially double dipped.” Ryan stressed the need to fix CMS’ misguided new cuts for oxygen concentrators in rural areas and HME’s important role in protecting...

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On Friday, CMS updated its Durable Medical Equipment Center page with information on implementing provisions in the CURES bill signed into law earlier this month.  The update covers the additional 6-month delay to the application of bidding-derived pricing reductions for complex rehab technology accessories used with Group 3 power wheelchairs, as well as retroactive relief for the second phase of bidding-derived cuts for rural and non-bid area providers from July 1 through Dec. 31,...

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CMS CLAIMS "VERY FEW BENEFICIARY COMPLAINTS AND NO NEGATIVE IMPACT ON BENEFICIARY HEALTH STATUS" UNDER BIDDING PROGRAM CMS today released Single Payment Amounts (SPAs) for 2017 Round 1, as well as this statement which includes the assertion that "very few beneficiary complaints and no negative impact on beneficiary health status" have resulted from the program. AAHomecare's statement on these claims about impacts on beneficiaries follows below. AAHomecare will...

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Home medical equipment providers who serve our nation’s military personnel are being hit with shocking new Medicare reimbursement cuts thanks to the Centers for Medicare and Medicaid Services’ (CMS) decision to widely apply rates from its competitive bidding program outside its original footprint in metro areas to now encompass the entire country. In addition to causing financial hardship and access issues for beneficiaries and the home medical equipment providers who serve them in...

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Last week, CMS announced that medical necessity no longer has to be met for initial replacement of essential accessories for a beneficiary-owned CPAP device or RAD.  CMS and CMS contractors will now assume that beneficiary-owned CPAP devices and RADs have met their medical necessity requirements through the 13-month continuous usage. This policy only applies to replacement of accessories, and this policy does not apply to devices that have been used for less than 13 continuous months or devices...

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The HME community is apprehensively counting down until July 1, the deadline for implementation of phase II of CMS’ flawed competitive bidding process to non-Competitively Bid Areas (CBAs). Congress must act now to stop the spread of bidding to additional rural areas and keep this program from further decimating the home medical equipment safety net that supports some of our most vulnerable patient populations.     Why Is This Program Detrimental? Phase I of...

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Reports To: President/CEO Position Summary  The Senior Director of Payer Relations is responsible for developing relationships and reference materials to assist membership in navigating payer relationships and concerns.  This person will serve as a resource in guiding members through relationship development with Medicare Advantage, Managed Care, and Medicaid payers.   This position will work with key leadership and the payers and/or CMS for overarching payment and audit...

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