CRT Sales Tax Exemption
WASHINGTON, D.C. – PAMES and Washington mobility suppliers are working closely with patient advocates to build support for legislation to create a sales and use tax exemption for Complex Rehab Technology (CRT) products in the state.
Suppliers, patients, and disability advocates testified in support of S-5218 in a hearing before Ways & Means of the Washington Senate yesterday. In addition, PAMES and the patient groups helped spur 95 individuals and organizations with a stake in the issue to register their support for the bill with the Committee in advance of the hearing.
AAHomecare shared a letter of support for the legislation to go along with written testimony and documentation from groups including NCART, Association of Academic Health Centers, Gleason Foundation, MS Society, Here and Now Association, U.S. Rehab, and National Seating & Mobility. Don Whitney (Inland Medical and Rehab), Bryce Schaffner (Bellevue Health), and Shawn Latham (Allies in Advocacy) testified at the hearing.
See PAMES’ background paper for more information.
PHE Ending May 11: A Look Ahead
WASHINGTON, D.C. – The Biden administration recently announced its intention to conclude the COVID-19 Public Health Emergency (PHE) on May 11, 2023. Under the latest PHE declaration in effect since January, the PHE was set to run through at least April 11.
As we noted in our related alert, the announcement of the end date for the PHE underscores the importance of last December’s Omnibus legislation provisions extending 75/25 blended rates for suppliers in non-rural/non-CB areas until the end of 2023.
The financial impact of the Omnibus win is clear: the 7+ month extension past the end of the PHE translates to about $30 million in additional reimbursements for HME, based on CBO scoring for that provision. All told, the three years and 10 months of 75/25 relief granted have added about $190 million to the bottom line for HME suppliers, based on CBO projections on this measure. It’s also worth noting that those non-rural rates also influence other payers who peg reimbursements to these rates, including Medicaid rates in 21 states as well as TRICARE.
With a mid-May end-date for the PHE established, HME stakeholders can now focus their advocacy efforts on extending the non-rural relief beyond December 2023 and on better aligning Medicare reimbursements in former CBAs with market reality through a 90/10 blended rate in those areas. Given the higher product and operational costs facing the HME community since the last completed and implemented bidding round in 2015, true market-based reimbursements are long overdue.
Continuing Coverage for CGM and Oxygen Patients
The announcement also adds urgency to efforts to maintain coverage for oxygen and continuous glucose monitor (CGM) patients granted under relaxed PHE requirements beyond the end of the PHE.
Under the PHE waivers, HME suppliers have provided CGMs to Medicare beneficiaries who use insulin less than three times per day (as required under the existing glucose monitoring LCD), or in some cases individuals who use no insulin at all, if the beneficiary’s provider demonstrated the medical necessity. This past October, the DME MACs proposed to modify the CGM policy criteria to expand coverage such as including patients not using any insulin but who are experiencing problems managing their glucose levels.
This week, AAHomecare sent a letter to medical directors at DME MACs to finalize their proposed LCD with those measures by March 27, 2023 to prevent lapses in coverage for these CGM users. See the letter here.
AAHomecare is also working with respiratory stakeholders to ensure access for oxygen patients who qualified for coverage under PHE waivers.
CMS Updates on Medicare Flexibilities and Medicaid Enrollment
CMS has issued updates related to unwinding Medicare and Medicaid waivers and policy changes tied to the PHE.
In a Feb. 6 Public Health Emergency Resource Update, CMS noted that December 2022 Omnibus legislation included an extension of the major telehealth waivers initiated during the PHE, and also shared a link detailing the full scope of COVID-19 waivers and flexibilities. An updated summary of DMEPOS-related waivers can be found here; guidance includes both currently-in-effect waivers and discontinued provisions.
Last week, CMS released guidance to state health officials related to Medicaid and CHIP programs on unwinding the Medicaid continuous enrollment condition and other issues related to the end of the PHE. The Agency also issued an FAQ on a temporary Exceptional Circumstances Special Enrollment Period (SEP) from March 31, 2023 through July 31, 2024 for consumers losing Medicaid or CHIP coverage due to the unwinding.
Consumers can find contact information for their state Medicaid or CHIP agency via this resource, which provides state Medicaid or CHIP agency enrollment links and contact information for each state.
New Resources On Auditing Entities And Contacts For Jurisdictions B And C
WASHINGTON, D.C. – CGS, the DME MAC for Jurisdictions B and C, developed two resources for DMEPOS suppliers based on feedback from Jurisdiction Council members. The Auditing Entities sheet lists all the Medicare review contractors and a description of their projects
The DME Whom to Contact List sheet has all the contact information for the different departments suppliers can contact at CGS and other review contractors. AAHomecare thanks CGS for developing these helpful documents for the DMEPOS suppliers.
