HME News

NOV 2017

HME News is the monthly business newspaper for home medical equipment providers. This controlled circulation publication reaches 17,100 home medical equipment services providers, including traditional HME dealers & suppliers, hospital- and pharmacy-o

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News ■ The administration is aware of issues with the bidding program, says AAHomecare's Tom Ryan. See story page 1. Stakeholders wage protracted battle with payers . . . . . . . 4 Texas update: Providers still wary of Medline contract. . . 4 CMS unveils new Medicare card . . . . . . . . . . . . . . . . . . . . . 4 New audit program emphasizes education . . . . . . . . . . . . 6 4 hme news / november 2017 / Where community meets opportunity Join the VGM community today! 1-800-642-6065 | Get a taste of what our thought leaders have to offer! MEDTRADE 2017 VGM-sponsored Power Lunch PLUS 15 education sessions designed to help your business with • Billing and Reimbursement • Aging in Place • Audits and Compliance • Web Marketing • Incremental Sales and Retail • Cybersecurity By Liz Beau L ieu, e ditor AUSTIN, Texas – The state Medicaid program may have forced Superi- or HealthPlan to modify its con- tract with Medline for DME and supplies, but HME providers say they fear not much has changed in reality. During a hearing in August that prompted the modifica- tions, for example, provider Barry Johnson says the state and Superior HealthPlan agreed that Medicaid recipients would be able to opt-out of the contract with a simple phone call to the managed care organization. "Now they're being told they have to fill out an opt-out form specifically from Superior HealthPlan," said Johnson, presi- dent of Texas Medical in Dun- canville, Texas, and executive director of the state HME asso- Nerves rattled in Texas ciation. "Why are they making this more difficult than it has to be?" In August, Superior Health- Plan, part of Centene Corp., which has more than 12 million members in 28 states, agreed to recast the contract with Med- line as "preferred provider," as opposed to "single source." It also agreed to delay the start date of the contract from Sept. 1 to Oct. 1. Adding insult to injury: John- son said he noticed way at the bottom of Superior HealthPlan's opt-out form that it's good for only one year. "So a year from now, we're going to have to go through this same exercise," he said. In late September, Johnson said "some" of his patients had gone through the opt-out T e x A S s e e pa g e 6 Briefs cms offers look at new m edicare card WASHINGTON – CMS has unveiled its newly designed Medicare card. The new card contains a unique, randomly assigned number that replaces the current Social Security-based number. "The goal of the initiative to remove Social Security num- bers from Medicare cards is to help prevent fraud, combat identify theft, and safeguard taxpayer dollars," said CMS Administra- tor Seema Verma, in a press release. CMS will begin mailing the new cards to people in April 2018 and must replace all existing Medicare cards by April 2019. Healthcare providers and people with Medicare will be able to use secure look-up tools that will allow quick access to the new Medicare numbers when needed. There will also be a 21-month transition period where doctors, healthcare providers and suppliers will be able to use either their current SSN-based Medicare number or their new, unique Medicare number, to ease the transition. medtrade booth 1627 By Theresa F L aher T y, Managing e ditor A r ECENT DECISION by the Washington, D.C., Med- icaid program to raise reimbursement for competitive bid items was a win, but stake- holders say it's a constant battle to keep payers from lowering pay- ments in the first place. "We are continuing to see the different payers, whether that be state Medicaid programs (or others), adopt Medicare rates or a discount below Medicare rates," said Laura Williard, vice president of payer relations for AAHomecare. "In some cases, they are just lowering rates and Stakeholders wage protracted battle saying it's because of the trends they are seeing in Medicare." The District of Columbia Health Care Finance Office said in September it would raise the reimbursement for competi- tive bid items to 100% of bid rates starting Oct. 1. Previously, these items had been paid at 80% of Medicare rates, but offi- cials reversed their decision after outreach from The Maryland- National Capitol Area Homecare Association and AAHomecare. On the commercial payer side, Blue Cross Blue Shield, in particular, is looking at Medicare fee schedules in several of the 36 b AT T l e s e e pa g e 6 No N -medicare payers

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