Page 10 - HME Business, March 2018

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Industry Advocates
Continue Pushing
Interim Final Rule
AAHomecare urges providers to replicate MAMES effort to push OMB to approve an IFR that would resume blended rates for rural providers still reeling from bid expansion.
Audit Key Gives Sneak Peak at Benchmarking Report
Prototype of the audit survey data shows a variety of ways providers can compare their audit performance
to industry averages.
The Audit Key survey program, which surveys the impact of Medicare claims audits on HME providers, is showing a sneak peak at one its new bene ts: a benchmarking report.
The latest round of the survey started on
Jan. 15, and brought with it a new bene t for providers that participate in two consecutive rounds of the program: access to a benchmark report that allows them to see how their company compares to other participants.
The report helps participants compare their audit performance with aggregate results to see how they stack up against national averages on topics such as DME MAC prepay audit denials, or new patients subject to audits in selected categories.
A 10-page prototype of the report, available at bit.ly/2Exp9vO, provides a summary of the sorts of data points that Audit Key users will receive.
Also, previously a quarterly research endeavor, Audit Key will now collect data every half year, according to the American Association for Homecare, which runs the survey.
“We believe the change to a twice-yearly format will allow more HME suppliers to participate in the program, which in turn will strengthen the validity of the survey ndings,” noted AAHomecare President and CEO Tom Ryan in a statement from the association.
The Audit Key program aims to help the industry better understand the impact of Medicare claims audits, and provide detailed information on Capitol Hill in order to better advocate for legislative and regulatory changes to CMS’s audit program.
“For those of you who have not yet participated, or have not submitted data in recent rounds, we hope you will consider submitting your data in the next round,” Ryan noted. “Your data is critically needed to help AAHomecare make the case for reforming Medicare audits
for HME.” n
While much of the industry
is working to advance co-sponsorship of H.R.
4229, the American Association for Homecare is reminding providers and industry advocates to also urge lawmakers to ask Of ce of Management and Budget Director Mick Mulvaney to release an Interim Final Rule (IFR) that could bring competitive bidding relief to rural providers and patients.
The IFR, which has been sitting at the Of ce of Management and Budget since August, would resume the 50/50, blended fee schedule for rural and non-bid areas that was in effect during the phase-in of national bid expansion during Jan.
1, 2016 to June 30, 2016, and apply it to claims submitted between Aug. 1, 2017 to Dec. 31, 2018. It would also exclude home infusion drugs used with HME from competitive bidding.
AAHomecare’s reminder to HME stakeholders comes after a concerted effort by Midwest Association for Medical Equipment Services & Supplies (MAMES) President Patrick Naeger. Efforts by Naeger, executive vice president of Duluh, Minn.- headquartered Healthcare Equipment and Supply Co., resulted in Rep. Blaine Lutkemeyer (R-Mo.) calling Mulvaney on the issue, and Sen. Roy Blunt (R-Mo.) sending a letter to the OMB Director’s of ce.
Blunt’s letter (available at bit.ly/2DVuy2X) asks Mulvaney to approve the IFR, and emphasizes that many of the Senator’s constituents “will have no choice but to transition to full-time skilled nursing facilities if they do not have access to DME that makes it possible for them to remain independent and in their homes for a fraction of the cost.”
“I can’t stress enough the need to keep the pressure on at OMB,” Naeger said. “While the legislative effort is important, we do not have
the luxury of time, for we are seeing this industry shrink and many are struggling to stay in business! We need an all-hands-on-deck approach to gure out who can best in uence Director Mulvaney.”
“We’ve heard other reports that both Senate and House members have reached out to OMB
to make similar requests thanks to outreach from HME leaders, and we strongly encourage you
to ask your legislators to do the same,” noted AAHomecare President and CEO Tom Ryan.
A statement from AAHomecare listed some key discussion points providers can use when calling their lawmakers regarding the IFR:
• CMS sent the IFR to OMB in August. It would
replace the unsustainable full cuts and replace
them with the blended rates.
• The cuts are also negatively impacting bene cia-
ries of TRICARE, Medicaid, and other payers that base their reimbursement on the Medicare fee schedule. The cuts or many HME products have been by as much as 40 percent to 50 percent.
• How the cuts are impacting the provider’s busi- ness and patients.
• Then ask the lawmaker to please contact Director Mulvaney and ask that he approve the IFR. n
UPCOMING COVERAGE
More industry intelligence is available at hme-business.com.
Developing Stories — Read HME-Business.
com and subscribe to e-Source during March to monitor key stories, including our coverage of Medtrade Spring; the industry’s push to advance H.R. 4229, which would provide rural bidding relief and x the oxygen “double dip;” and H.R. 3730, which would protect access to manual CRT wheelchair accessories; and the industry’s effort to advance the IFR on rural bidding relief.
e-Source — Sign up for our weekly e-newsletter, e-Source, to ensure you stay up to date on the latest industry news, trends and developments. You can enter your email address on the hme-business.com homepage to subscribe.
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