The American Association for Homecare (AAHomecare) is calling on the contractors administering TRICARE military health plans nationwide to reprocess claims for home medical equipment for the last six months of 2016 on account of provisions in recent healthcare legislation affecting Medicare reimbursement rates.
Last year’s CURES Act required the Centers for Medicare and Medicaid Services (CMS) to retroactively adjust payments for home medical equipment to rates in effect before July 1. As TRICARE rates are pegged to Medicare reimbursement rates by law and by current network agreements in place, AAHomecare and the home medical equipment community believes that TRICARE plans are obligated to follow suit.
“Congress recognized the need to provide relief for home medical equipment companies operating under drastic Medicare reimbursement cuts,” noted AAHomecare president & CEO Tom Ryan. “It’s clear from current statutes and regulations that this relief is also applicable to the TRICARE program.”
“It is important that we fully examine how the CURES legislation will affect all payers for the HME industry,” said Laura Williard, AAHomecare’s senior director of payer relations, who is spearheading efforts to build better relationships with the full range of payers for the HME sector beyond Medicare. “Today’s letters are a first step in making TRICARE contractors aware of the changes in the fee schedules and starting the process of working with them to develop a plan that will ensure providers are paid accurately.”
“AAHomecare is committed to serving as a strong advocate for HME to all payer segments,” Williard continued. “I look forward to both working directly with the TRICARE contractors and also developing the resources providers need to engage the contractors themselves.”
AAHomecare has worked with leading healthcare attorneys to confirm the Association’s assertion that TRICARE should comply with the CURES legislation and reprocess claims, and has laid out its arguments in a letter being sent to the three national TRICARE administrators and the Department of Defense. AAHomecare will also be providing guidance for its members in reaching out to TRICARE contractors to encourage them to quickly address this issue.
“Home medical equipment providers take special pride in serving our nation’s military personnel and their families,” added Ryan. “We urge TRICARE to let our providers know how they plan to comply with the CURES legislation as quickly as possible so they can continue to support the military community’s healthcare needs.”
The American Association for Homecare represents durable medical equipment providers, manufacturers, and others in the homecare community that serve the medical needs of millions of Americans who require oxygen systems, wheelchairs, medical supplies, inhalation drug therapy, and other medical equipment and services in their homes. Members operate more than 3,000 homecare locations in all 50 states. Visit www.aahomecare.org.
Gordon Barnes, email@example.com, 202.372.0759