The National Association for Homecare (NAHC) is laying the groundwork for a possible lawsuit against CMS’ implementation of the Affordable Care Act’s (ACA) home health face-to-face requirements. NAHC says that providers are frustrated with face-to-face denials and...


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Reimbursement
Call to action! Join the fight to add DME to the SGR fixes.
Please click on this link, www.vgmdclink.com, to send a message to your members of Congress. Complete both Actions 1 and 2 to send one to your senators and another to your representative. PAMS and VGM are asking the representatives to act on these three items: 1. Add...
Medicare to cover hospice and curative care simultaneously in new demonstration program
Medicare will reimburse both hospices furnishing palliative care and providers offering curative services under a new demonstration program, the Centers for Medicare & Medicaid Services recently announced. Currently, a beneficiary must end curative treatments in...
AAHomecare: Congressmen Thompson and Braley push to Stop Competitive Bidding
Representatives Glenn Thompson (R-Pa.) and Bruce Braley (D-Iowa) have drafted a strongly worded letter to CMS Administrator Marilyn Tavenner citing problems with Medicare's bidding program for home medical equipment. The letter asks CMS to refrain from further action...
HME News: CMS seeks to not only spread bid rates but also bundle payments
Last week’s proposal to expand competitive bidding nationwide was likely a rude awakening for HME providers who have been sitting on the sidelines thinking that the program wouldn’t directly affect them, say stakeholders. “Many folks thought it was going to crash and...
Face-to-Face Requirement Language Added to LCDs and Policy Articles
On March 6, the Medicare audit contractors announced the addition of face-to-face language to the following local coverage determinations (LCDs) and policy articles: • Automatic External Defibrillators • Hospital Beds and Accessories • Manual Wheelchair Bases • Speech...
LCD and Policy Article Revisions Announced
On February 27, the Medicare audit contractors announced recent changes to local coverage determinations (LCDs) and policy articles on external infusion pumps, ostomy supplies, and pressure reducing support surfaces. External Infusion Pumps – This LCD revised Section...
DME Provisions Included in President’s 2015 Budget
President Obama released his 2015 budget this week, and, as expected, provisions targeting DME were included. Two of the prominent provisions suggest using Medicare bid rates for Medicaid reimbursement to save money, and implementing prior authorization as a means of...
NC Medicaid Reform Plan Rules Out Privatization
After a nearly yearlong effort, state health officials presented their plan for overhauling the North Carolina Medicaid program, revealing a retreat from plans to offer the $13 billion program out to bid to private managed care companies. Over the course of a...
Congressmen Urge Sebelius to Fix RAC Backlog
In a letter to HHS Secretary Kathleen Sebelius, 111 congressmen urged HHS to deploy additional resources to resolve the backlog of appeals of overpayments determined by Recovery Audit Contractors (RACs), to implement reforms in the RAC process, and consider...
ALJ Delays by the Numbers
At a recent Office of Medicare Hearings and Appeals (OMHA) hearing on delays in scheduling appeals at the administrative law judge (ALJ) level, AAHomecare President Tom Ryan told OMHA Chief ALJ Nancy Griswold that when he hears stories of providers with patients who...
Interest Rate Increase for Medicare Overpayments and Underpayments
On January 21, the new interest rate on Medicare overpayments and underpayments became 10.25 percent, a 0.125 percent increase. Interest on payments accrues from the date of the initial request for refund and is assessed for each 30-day period, or portion thereof,...




