Via AAHomecare, WASHINGTON, D.C. (November 30, 2017)—As mandated in the December 2016 CURES bill, federal Medicaid reimbursement to states for home medical equipment cannot exceed what Medicare would have allowed for these items beginning on January 1, 2018.
Since the start of this year, AAHomecare has been working with state Medicaid programs, state/regional associations, stakeholder groups, legal counsel and CMS to obtain guidance and offer direction and recommendations to ensure that the Medicaid programs understand their rights in managing their program and their responsibilities to ensure access to care under these new requirements.
AAHomecare has met multiple times with CMS to obtain information on what guidance will be issued to the states. At the most recent meeting, additional information was obtained related to this notice in the Federal Register published by CMS that Medicaid agencies will need to show they are complying with this regulation by annually reporting their claim payments for specific HCPCS codes which include K and E codes and a few select A codes.
AAHomecare has been informed that a State Medicaid Directors letter will be issued soon with additional guidance. There will also be a State Operational and Technical Assistance call held on December 7—AAHomecare will be participating and will provide further information.
State Medicaid programs do not have to set their rates at a Medicare allowable. States will continue to have the flexibility to set their own rates to ensure access to care. However, given the fact that the Federal match is being reduced to reflect Medicare rates, the association expects many states will feel compelled to lower fee schedules accordingly. AAHomecare will provide support to state/regional association leaders and other stakeholders in advocating for sustainable Medicaid reimbursement rates under these new program requirements.
See the issue summary on the CURES Medicaid requirements, or contact Laura Williard at LauraW@aahomecare.org for more information.
Visit aahomecare.org for more information.
