Page 8 - HMEB Business, February 2017

News / Trends / Analysis
CMS Releases More Details on CURES Act Implementation
CMS provides update on additional six-month delay of bid expansion pricing, other elements of newly approved law, but doesn’t provide
CMS has updated its Durable Medical Equipment Center page with informa- tion the 21st Century CURES act, which the 114th Congress passed and President Obama signed into law.
The main issue that the updates address is that the CURES Act provides retroactive relief to non-bid providers by extending the initial phase of partial reimbursement cuts to impacted items. That phase- in original ended on June 30, 2016, but the CURES Act pushed that to a Dec. 31, 2016 end date.
Per section 16007 of the law, CMS must reim- burse claims made after July 1, 2016 and before Jan. 1, 2017 with the difference between the full
reimbursement cuts and the partial, phase-in rate. In the updates to the DME Center page,
CMS said it is “currently working to implement this section [16007] and will be providing contractor instructions for re-processing the applicable claims.” The agency added that suppliers aren’t required to take any action for the moment.
What the update does not specific is exactly when providers can expect to see the recoup- ments for the full cuts to which their post-July 1, 2016 claims were subjected.
Another chief concerned was the impact on CRT. The update also acknowledged that section 16005 of the Act delays the application of competitive
bidding-derived reimbursement cuts to accesso- ries for Group 3 complex rehab mobility devices another 12 months until July 1, 2017. (A previous 12-month extension had previously been secured in December 2015.)
CMS’s update stated that to implement the extension, it updated the 2016 KU fee schedule amounts by the 2017 0.7 percent covered item update, which will be added to the 2017 DMEPOS fee schedule file. The agency instructed providers to continue using the KU modifier when billing for wheelchair accessories and seat and back cushions furnished in connection with Group 3 complex rehab power wheelchairs with dates of service Jan. 1 through June 30. n
WEBINARS
More industry intelligence is available at hme-business.com.
Free Upcoming Webinar — HME Business will
be hosting “Wound Care: Picking the Right Path for Your Business,” on March 28, which will be free of charge thanks to the generous sponsorship
of McKesson. The webinar will be presented by Heather Trumm, the director of wound care and bariatrics for The VGM Group Inc, who will explore the various business models providers can choose when expanding into this important and lucrative product segment. To learn more and register for this free educational opportunity, visit hme-busi- ness.com/webinars.
Free On-Demand Webinar — Our latest free, on-demand webinar is “The Connected HME:
Why Interoperability Should be Your Business Imperative,” which focuses on the need for providers to ensure they have seamless IT interop- erability. Sponsored by Brightree LLC, that webinar is presented by Nick Knowlton, co-founder of the Leadership Team and Membership Committee Chair at the CommonWell interoperability alliance, and vice President of Business Development at Brightree; Robert F. Boeye, executive vice presi- dent of Home Medical Equipment at Brightree; and Tammy Ordoyne-Vial, director of HME Operations at Ochsner Health System. Available at hme-busi- ness.com/webinars.
8 HMEBusiness | February 2017 | hme-business.com
Management Solutions | Technology | Products
States, AAHomecare
Study Response to Bid
Pricing for Medicaid
Component of recently approved CURES Act limits Federal portion of Medicaid spending to competitive bidding prices for affected DME items, starting in 2018.
The State Leaders Council of the American Association for Homecare, which is comprised of leaders form the various state HME associations, has formed a Work Group to develop strategies for dealing with the provision in recently passed CURES legislation that limits the federal portion of Medicaid spending to competitive bidding prices for affected DEM items, starting in 2018.
The Work Group is investigating how much flex- ibility states have in Medicaid rate-setting under the CURES Act, as well as how the industry can educate state Medicaid directors about their options under the new law. The messaging crafted by the Work Group will clarify the states’ level of autonomy in determining their rates, and reinforce the value of HME as a cost-effective healthcare asset that delivers better patient outcomes.
“We’re excited to expand the focus of AAHomecare’s partnership with our local HME associations to tackle increasing state issues facing
our members as a result of the changes mandated in the CURES Act that affect Medicaid reimburse- ment,” said Kam Yuricich, who, in addition to chairing the Work Group and the State Leaders Council, serves as the Executive Director for the Ohio Association of Medical Equipment Suppliers and the Great Lakes Home Medical Services Association. “This is truly when strong coordinated team work matters for our members.”
AAHomecare is also engaging with the National Association for Medicaid Directors about the impact of the CURES-mandated provision on Medicaid programs, and what states can do
to overcome shortages created by the federal portion of the Medicaid budget. A statement from the association said it will work with the new Administration and key committees of jurisdiction to determine how this program will work for the Medicaid programs and the potential impact on Medicaid Managed Care plans. n