CMS Announces Flexibilities in Response to California Wildfires The Centers for Medicare & Medicaid Services (CMS) has announced flexibilities in response to ongoing wildfires that began last week in Southern California. In a Jan. 10 news alert, CMS said state of California waivers are available for affected providers. Medicare beneficiaries who have lost their durable…
Briefly: CMS Announces California Wildfire Flexibilities; First 2025 Abilities Expo Scheduled for March
ITEM Coalition Sends 75/25 Reimbursement Rate Letter to Congressional Leaders
More than 30 advocacy organizations urged Congress to improve funding rates for home medical equipment.
The ITEM Coalition has sent a letter to Congressional leaders to urge their support for the reinstatement of the Medicare 75/25 blended reimbursement rate for home medical equipment. In a Dec. 2 letter, the ITEM Coalition noted that the expiration of the 75/25 reimbursement rate in January has hurt patient access to durable medical equipment…
CMS Wants to Prevent ‘Barriers to Care’ in Medicare Advantage Programs, Add Guardrails Around AI
The Centers for Medicare & Medicaid Services announced policy changes last week.
The Centers for Medicare & Medicaid Services (CMS) is looking to further crack down on the companies that administer the privatized version of Medicare. On Nov. 26, CMS proposed new policies aimed at holding Medicare Advantage (MA) plans more accountable while removing “unnecessary barriers to care” for Medicare beneficiaries. The policies target “inappropriate” prior authorization…
Nov. 6 HCPCS Public Meeting to Include Discussion on CRT Seat Elevation, Joystick Hardware
NCART and Palmetto GBA have asked the Centers for Medicare & Medicaid Services to make coding changes.
The Nov. 6-8 second biannual HCPCS public meeting includes a request to revise the Medicare reimbursement for HCPCS code E2298, defined as Complex rehabilitative power wheelchair accessory, power seat elevation system, any type.” The applicant — the National Coalition for Assistive & Rehab Technology (NCART) — is recommending that language be changed to “Complex Rehabilitative…
House’s Power Standing Coverage Determination Letter Sent to CMS with 22 Signatures
The Complex Rehab Technology industry continues to push for a Medicare coverage determination for power standing on power wheelchairs.
The “Dear Colleague” letter from members of Congress was sent to Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure with 22 signatures. In an Oct. 16 bulletin, the National Coalition for Assistive & Rehab Technology (NCART) updated stakeholders on the Complex Rehab Technology (CRT) industry’s latest effort to urge CMS to open the…
Commentary: CRT As Prevention? What a Concept!
A new report published by VGM & Associates suggests Medicare competitive bidding has run its course.
A new report, authored by Brian Leitten of Leitten Consulting and published by VGM & Associates, contends that the Centers for Medicare & Medicaid Services (CMS) has taken the wrong perspective of durable medical equipment (DME) for at least for the last two decades. The 2003 Medicare Prescription Drug, Improvement, and Modernization Act gave rise…
‘Dear Colleague’ House Letter Urges CMS to Open Coverage Determination for Power Standing
The deadline for representatives to sign onto the letter is Sept. 27.
Rep. Brian Fitzpatrick (R-Pa.) and Rep. Debbie Dingell (D-Mich.) have penned another “Dear Colleague” letter asking the Centers for Medicare & Medicaid Services (CMS) to open a coverage determination for power standing on power wheelchairs. “Please contact your U.S. representative today and urge them to sign on to the Dingell/Fitzpatrick Congressional sign-on letter urging CMS…
NCART Announces Appeal of Medicare CRT Seat Elevation Allowable
In June, CMS increased the allowable by $13.62.
The National Coalition for Assistive & Rehab Technology (NCART) is appealing the latest Centers of Medicare & Medicaid Services (CMS) allowable decision for seat elevation on Complex Rehab Technology (CRT) power wheelchairs. In a July 17 bulletin, NCART said it had submitted a HCPCS coding application “to formally appeal” the CMS decision to increase that…
AAHomecare Survey Asks How Medicare Cuts Are Impacting Beneficiary Access
The Medicare 75/25 blended relief rate for non-bid/non-rural areas ended Jan. 1.
A new survey from the American Association for Homecare (AAHomecare) is asking home medical equipment (HME) suppliers how Medicare funding cuts are affecting their businesses and impacting beneficiary access to medically necessary equipment. In a July 8 news announcement, AAHomecare announced a national survey “on the impact of the expired Medicare fee-for-service 75/25 blended rate…
Carelon Takeover of Medicaid Authorization for Maryland, Missouri, Wisconsin Now on Hold
Carelon was due to start handling prior authorization requests on July 1.
The July 1 transition that would have transferred prior authorization requests to Carelon Medical Benefits Management for Medicaid programs in Maryland, Missouri, and Wisconsin has been put on hold. In a June 28 bulletin, the American Association for Homecare (AAHomecare) said the transition “has been postponed until further notice. Suppliers in Maryland, Missouri, and Wisconsin…