WASHINGTON, DC – The House Ways & Means Committee today approved legislation by unanimous voice vote that includes provisions to permanently exclude manual CRT wheelchairs from the competitive bidding program and exempt manual CRT accessories from bidding-derived pricing for 18 months, starting on July 1, 2019. The CRT language is part of HR 3429, the “HEARTS and Rural Relief Act’’ introduced by Reps. Terri Sewell (D-Ala.) and Devin Nunes (R-Calif.), which also covers healthcare access for former military service members as well as payment transparency for ambulatory surgical centers.
Reps. Sewell and Nunes both spoke in favor of the CRT provisions during the mark-up session, as did Reps. John Larson (D-Conn.) and Mike Kelly (R-Pa.).
The CRT language in the bill mirrors bill mirrors text from HR 2293, legislation that AAHomecare and other mobility stakeholders have been supporting since both were introduced in April.
“This is a very positive development for protecting patient access to a broad range of CRT wheelchairs and accessories,” said Tom Ryan, AAHomecare President & CEO. “AAHomecare and NCART members, along with patient advocacy groups like the ITEM Coalition and United Spinal Association, have been very persistent in their advocacy on manual CRT. It’s gratifying to see those efforts starting to pay off, but there’s still a lot of work ahead to get this ball passed into law.”
AAHomecare will work to build support for the new legislation and urges companies in the mobility space to contract their Representatives and ask that they co-sponsor H.R. 3429.
You can see draft language for the bill here. CRT-related provisions begin on page 13.
South Carolina Medicaid Rate Changes Include Protections for Key Categories
WASHINGTON, DC – The South Carolina Medical Equipment Services Association (SCMESA) and AAHomecare have developed a strong relationship with South Carolina Medicaid (SC Medicaid) in recent years, and that relationship proved beneficial for DME providers in the state this week.
Several months ago, SC Medicaid began discussions with SCMESA and AAHomecare on changing their rates to mirror Medicare’s non-rural rates, an approach favored by a consulting firm hired by the state. When the SCMESA Medicaid Committee pointed out the access issues that simply adopting Medicare rates would have on the state’s most vulnerable population – particularly in rural areas – we caught their attention and jump-started negotiations.
This week, SC Medicaid officials reported they will exempt key product categories from the rate change in order to maintain adequate access to care. The protected categories include; oxygen, PAP, PAP supplies, ventilators, nebulizers, enteral, hospital beds, wheelchairs, and some specific wheelchair accessories.
“SCMESA is most appreciative of the work of Laura Williard and David Chandler of AAHomecare with the South Carolina Medicaid program relating to reimbursement rates for DME,” said Bobby Horton, executive director of SCMESA. “Laura‘s efforts on behalf of South Carolina DME providers, working alongside our Medicaid Relations Committee, have been very effective in minimizing rate decreases, while a majority of codes will realize increasing reimbursement rates. We look forward to working with her on similar efforts focusing on Medicaid MCOs.”
“This win was truly a team effort,” remarked Laura Williard, vice president of payer relations for AAHomecare. “We’re proud to have partnered with SCMESA to help protect patient access across several DME product categories.”
Of the 989 DME HCPC codes on the South Carolina Medicaid fee schedule, 568 will receive increases, 188 will be decreased, and 233 codes will stay the same.
White House Executive Order Could Pave the Way for Better Access to Healthcare Data
WASHINGTON, DC – On Monday, President Trump released an Executive Order aimed at improving transparency on prices and quality for healthcare, with a principal aim of giving patients more information to help guide decisions related to their own care.
While much of the attention and media coverage surrounding the order has focused on provisions requiring hospitals and other healthcare providers to offer more up-front information on pricing, the order also includes a directive to “increase access to de-identified claims data from taxpayer-funded healthcare programs and group health plans for researchers, innovators, providers, and entrepreneurs.”
The Order also directs HHS and other agencies to establish a health quality roadmap “to align and improve reporting on data and quality measures across Medicare, Medicaid, the Children’s Health Insurance Program, the Health Insurance Marketplace, the Military Health System, and the Veterans Affairs Health System.”
AAHomecare believes that increased access to government healthcare data, particularly in Medicare and Medicaid programs, will better allow us to demonstrate the cost-effectiveness and clinical value of HME products and services, and also provide a better environment for research on the far-ranging impacts of policies that reduce access to HME.
See more in the June 24 Executive Order. Details on the health quality roadmap can be found in Section 4; increased access to healthcare data is found in Section 5.