Moving the HME Industry Forward

Legislative/Advocacy

Survey Underway to Measure PMD Prior Auth Demo Success

May 12, 2018

Suppliers in the 19 states currently subject to the Power Mobility Devices Prior Authorization Demonstration Project are encouraged to take a brief online survey to provide feedback on their experience with the demonstration.

The survey is being spearheaded by a work group in AAHomecare’s Complex Rehab & Mobility Council (CRMC) that will be providing feedback to CMS on the demonstration project, which is currently slated to end August 31st. Click here to take the survey; responses are due by Friday, May 25th.

“The PMD Prior Authorization program has been a win-win for the HME Industry and for CMS, and information from this survey will bolster our efforts in working towards a nationwide, permanent prior authorization program for PMDs,” explains council chair Nancy Froslie of Sanford Healthcare Accessories.

The Council is also preparing a white paper that articulates the positive results of the demonstration project and outlines regulatory opportunities to expand prior authorization for PMDs after the conclusion of the demonstration project this Fall. For additional information, contact Ashley Plauché (pictured), AAHomecare’s manager of government affairs at ashleyp@aahomecare.org.

IFR to Increase “Rural” Rates For 7 Months, Starting June 1

WASHINGTON, DC – CMS has just released details on the long-awaited Interim Final Rule related to HME.  According to their statement, today’s action resumes the 50/50 blended rate schedule staring for June 1 through December 31, 2018, in rural and non-contiguous areas not subject to the bidding program.  Full text of the IFR can be found here.

Tom Ryan, president and CEO, AAHomecare comments:

“Today’s action provides substantial and much-needed relief HME suppliers in rural areas — and also for patients, caregivers and clinical professionals in small communities nationwide. We are, however, very disappointed that the relief does not extend to non-bid areas that are not “rural” or “non-contiguous” (e.g. HI, AL). We strongly believe that more extensive relief is needed, this same relief should have been applied to the rest of the non-bid areas.  We are grateful for the limited relief; these adjusted rates will give suppliers in rural areas a chance to keep their doors open while we work towards much-needed long-term fixes for Medicare reimbursement and the bidding program.

“This omission of other non-bid areas stands in stark contrast to consistent Congressional intent to extend relief for all non-bid areas expressed in both the 2016 Cures law and other outreach to the Administration. We will continue to work with the Administration and our champions in Congress to expand the scope of relief to include suppliers in the remaining non-bid areas,” added Ryan. “We also believe that some measure of retroactive relief, as proposed in H.R. 4229 remains warranted, and we also need to address the uncertainly on these rates beyond 2018.
 
“We appreciate the important role that Congress has played in this process thus far. I believe their strong outreach to CMS and OMB, as well as the conference report language in the recent Omnibus bill encouraging the Administration to release the IFR, played a major part in getting this relief. We need to continue to engage our legislators to let them know that the job isn’t finished.
 
“This IFR is the culmination of a determined campaign by HME stakeholders to get relief for rural suppliers that stretches back over more than two years. There is more work to be done, and I hope I can count on the HME community’s continued passion and persistence to build on this measure of relief.”

AAHomecare will provide additional analysis on the IFR and its potential impacts on other payor segments in the coming days. Full text of the IFR can be found here.  See CMS’ release and related fact sheet for additional details.