Page 10 - HME Business, May 2017

News / Trends / Analysis
Providers Sound Off on CURES Act Call
HME stakeholders share their stories of how bid expansion has impacted their businesses and patients on CMS call; providers can still submit feedback via email.
Providers and HME stakeholders flooded onto a special CMS conference call to describe how competitive bidding-derived reim- bursement cuts were impacting their businesses and patients, particularly in rural areas.
The late-March call was required by the CURES Act, which mandated that CMS solicit and take into account stakeholder input — especially feed- back from rural providers — on a variety of factors
that the agency should then incorporate into how it adjusts fees in non-competitive bidding areas, beginning in 2019.
In addition to factoring in considerations such as the highest amount bid by a winning supplier in a competitive bidding area, CMS must also compare various factors with respect to non-competitive bidding areas versus competitive bidding areas, such as:
• Average travel distance and costs associated with furnishing DME/HME items and services in an area.
• Average volume of items and services furnished by suppliers in an area (which can be considerably lower for rural providers, for instance).
• The number of suppliers in an area.
And that’s exactly what providers on the call did. Some of the replies from the conference call:
“...When your cost exceeds the reimbursement, there’s a problem, and these people are going to go without,” noted Julia Humphrey of Reno, Nev. Respiratory provider Accellence Home Medical. “And that’s my biggest concern at this point. I don’t know how you can possibly service these
rural areas for the fee schedule that we’re receiving at this point.”
“...We deal with the rural areas not just here
in central Virginia but across the Blue Ridge Mountains,” said Ronnie Rankin of Culpeper Home Medical in Culpeper, Va. “Some of clients are hours, an hour and a half away. And that is only
if you don’t account any weather, which is pretty common with the mountainous area.”
“These prices were implemented for an area where the bid winners would see highly increased volume, so that they could give Medicare much reduced pricing,” said Josh Shieldsof Beta Med in Bryan, Texas. “In the rural areas, we do not see that increase in volume.”
All in all, providers exhausted the call’s feedback time (read the 34-page transcript), and providers who were unable to leave their feedback or could not attend the call were able to give CMS their feedback via email.
More information about CMS’s efforts to collect provider feedback and data is available at http:// go.cms.gov/2oFoJud. n
WEBINARS
More industry intelligence is available at hme-business.com.
Free On-Demand Webinar — Wound care can
put HME providers in the fast lane to increased profitability, but which is the right on-ramp for your business? Now available for free at hme-business. com/webinars, you can watch and listen to “Wound Care: Picking the Right Path,” which is available thanks to sponsor McKesson Corp. Presenter Heather Trumm, BSN, RN, CWON, the director
of wound care for VGM Group Inc., explains the market basics, the various wound care categories, and the payment opportunities for HME providers.
Free, Upcoming Live Webinar — Heather Trumm, BSN, RN, CWON, the director of wound care
for VGM Group Inc. returns to HMEB’s webinar “stage,” joined by her colleague Maria Markusen, director of Operations & Development for VGM Retail, to discuss how providers can take their wound care businesses to the next level. Slated for May 31, registration for this webinar is FREE thanks to sponsor McKesson Corp.
New Webinar Archive — The RAC is Back! Are you ready? CMS has given Performant Recovery, the new national Home Health, Hospice and DMEPOS RAC, the greenlight to start auditing. The first round of RAC audits, occurring in 2011 to 2013, were rough on providers. In this informa- tive webinar, presenter Kelly Grahovac, senior consultant for The van Halem Group, provides keen insights into what you can expect from the next round of this audit, and how you should be preparing to respond to those audits.
Register for all HME Business webinars at hme- business.com/webinars.
N.Y. Incontinence Rate
Change Pushed to May
Originally slated to go into effect April 3, implementation of rate cuts will go into effect May 17.
10 HMEBusiness | May 2017 | hme-business.com
Management Solutions | Technology | Products
The New York Department of Health will delay Medicaid reimbursement cuts for inconti- nence supplies that the The American Association for Homecare and the Northeast Medical Equipment Providers Association (NEMEP) were able to soften in March.
Originally slated to go into effect on April 3, the cuts will go into effect on May 17, giving Gotham State providers roughly six additional weeks to prepare.
The N.Y. Department of Health published
fee schedule changes that cut reimbursement
for incontinence product by approximately 30 percent, and were slated to go into effect on Feb. 15. However, the Department delayed the rate
reductions two weeks ago so that it could review cost study information provided to the agency by AAHomecare and NEMEP.
After reviewing that information, the Department opted for an average reduction of approximately 20 percent to go into effect on April 3.
“AAHomcare and NEMEP have continued to make the case for further lessening the cuts with the Agency by supplying additional information on provider costs we developed with New
York providers, and we are hopeful that this delay is a sign that they are taking this fresh input into consideration,” a statement from AAHomecare read. n