Funding


CMS Gives TennCare More Flexibility in Serving Beneficiaries

Under the new “block grant” waiver, the Tennessee Medicaid program will be able to service patients with less federal oversight. CMS approved the waiver for 10 years.

VGM Conducts New Delivery Cost Survey

A follow-up to its 2018 effort, the survey helps tabulate the cost of provisioning HME products and services. This new effort aims at understanding how COVID-19 has changed that cost structure.

UnitedHealthcare Extends COVID-19 Prior Auth. Suspensions

The extension pushes the previous expiration date from Jan. 8 to Jan. 31 and United noted that it includes oxygen can be delivered without prior authorization.

AAHomecare Submits Comments on DMEPOS Proposed Rule

Association suggested various alterations to the proposed rule released in November, including how rates for former CBAs and non-rural non-CBAs should be calculated.

Congress Upvotes COVID-19 Bill

House and Senate overwhelmingly voted to pass the second relief package of the year, which includes two key HME industry provisions.

Apria Settles $40.5M Whistleblower Case

U.S. Attorney’s suit alleged that the national provider continued to bill for non-invasive ventilators when it did not know if beneficiaries were using the devices.

AAHomecare: Contact Your Senators Right Away

The association is urging HME stakeholders to tell their Senators this week to extend the pause the CARES Act placed on Medicare’s longstanding 2 percent sequestration cut.

CMS Releases 2021 Fee Schedule

While there are some slight ups and downs, analysis from AAHomecare shows next year’s DMEPOS fee schedule aligns with expectations and reflects the changes made due to COVID-19.

Some Senate Republicans Unsure on Sequester Extension

Providers urged to call on GOP Senators to extend the pause on 2% sequester cuts through the duration of the public health emergency.

New House Bill Aims to Save COVID-19 Medicare Relief

H.R. 8840 would continue pausing 2% Medicare sequester cuts through the duration of the public health emergency. The curs are currently slated to resume Dec. 31.



Observation Deck

Cash Sales of Medicare-Covered Items

How much can a Medicare supplier's retail business charge for the items they supply to beneficiaries?

ALJ Appeals Backlog Continues Decline

OMHA reports to AAHomecare that within a year, the number of pending DMEPOS appeals fell by 51 percent.

AAHomecare: DMEPOS Needs Priority Vaccine Distribution Status

Association urges various federal officials that Phase 1 Distribution of a COVID-19 vaccine must include DMEPOS suppliers because of their close contact with patients.

AAHomecare Asks DOD for Support on TRICARE Claims

TRICARE West contractor HNFS is not reimbursing claims per the CARES Act rates. AAHomecare is urging providers to support a letter campaign.

CMS’s Round 2021 Announcement: It’s a Win

The decision to punt on 13 categories might leave some providers feeling a little in Limbo, but AAHomecare’s Tom Ryan stresses the industry should notch this as a ‘W.’ That said, some rough edges remain and there’s still work to do.

CMS Releases Proposed DMEPOS Payment Rule

Proposed rule covers various provisions, including continuing rural relief and removing manual CRT wheelchairs and accessories from bidding. Public comments will be due Jan. 3.

CMS Skips Round 2021 Contracts for 13 Categories

Agency only awards contracts for off-the-shelf back and knees braces, leaving the industry guessing on the exact fate of nearly all remaining categories.

CMS Meeting Offers Audits Update

Virtual edition of Provider Compliance Focus Group shared information on TPE audits and recommendations it made to the DME MACs.

CMS Extends AAP Program Repayments

Providers that received payments from the Accelerated and Advance Payment program now have significantly longer to repay their loans.

Annual Advisory Board Roundtable

COVID-19’s Tectonic Legal Shifts for HME

Legal expert Jeffery Baird discusses how the Public Health Emergency has already changed the legal landscape, and what else might be in store for HME providers.

HME Business Podcast