AAHomecare Presses Anthem on Rates

After insurer cut reimbursement in July despite COVID-19 costs, HME association highlighted the disparity between Anthem’s funding and Medicare’s rates for HME during the health emergency.

• By David Kopf
• Aug 27, 2020

The American Association for Homecare is continuing to pressure Anthem Inc. and its subsidiary Amerigroup after they doubled down on cuts on HME reimbursement ranging between 11 to 60 percent back in July.

At the time, AAHomecare engaged various Anthem executives, including President and CEO Gail Boudreaux, to convey how the COVID-19 public health emergency has increased costs for HME providers.

Now, in a new letter to Anthem, AAHomecare is continuing its efforts by the disparities between Anthem’s new rates for HME and Medicare’s rates both inside and outside of CBAs, as well as average rates currently in effect under the CARES Act.

The letter also underscores the short notice for suppliers, especially under the COVID-19 PHE, and reiterated the association’s desire in further discussing the rate reductions with Anthem’s leadership.

The letter also emphasized a point that AAHomecare initially made to Anthem and is continuing to make with payers and lawmakers: rates must be enough that providers can continue to serve patients while meeting the demands of the COVID-19 PHE.

“… The DME marketplace is not the same as six months ago when you completed your rate analysis,” the letter notes. “The cost and operational structure has changed drastically for providers in the near term, and many of the impacts of the COVID-19 pandemic will be felt by DME providers on a long-term basis.”