Georgia Association of Medical Equipment Suppliers
March 2 | 2017
In this issue:
GAMES Platinum Members!
GAMES Associate Members
Urgent Need to Contact Your State Rep.
GAMES Members - Please call your State Representative and ask them to support SB 41, the GAMES Durable Medical Equipment Licensure Bill!
AAHomecare Asks HHS to Set Rural/Non-CB Rates at Jan.-June 2016 Levels
From AAHomecare March 1, 2017
On Tuesday, AAHomecare asked HHS Secretary Tom Price to take immediate action to provide relief to DME providers and patients in non-CBAs by issuing an Interim Final Rule (IFR) that would repeal the full phase-in of the adjusted fee schedule rates in non-CBAs that was applied on July 1 (and are currently in place), and freeze rates at the blended rate that were in effect for Jan.-June 2016.
AAHomecare’s letter details the disruption that drastic reimbursement cuts for rural/non-CB providers has caused for both suppliers and beneficiaries, points out deficiencies in CMS’ original rulemaking that led to the new rate structure, and notes the Agency’s failure to provide a Congressionally-mandated report on the effects of the new rates in making the case for HHS action.
The letter also outlines the statutory authority for HHS to implement these changes through an IFR, and also points out that this action would align with current Administration policy to ensure that regulations are not so burdensome they hinder businesses’ ability to create and sustain jobs.
CLICK HERE for AAHomecare’s letter to HHS.
GAMES Winter Meeting a huge success!
On Friday, February 17, more than 80 of your peers and colleagues gathered in Atlanta to hear from expert speakers, engage in peer-to-peer dialogue, and network with vendors.
Be sure to mark your calendar now for May 11! Registration for GAMES Spring Meeting, Soup To Nuts-Building Your Compliance Program so you can still eat your soup and not go nuts!, is opening soon!
Georgia Medicaid CMO Meet and Greet this Friday!
The Georgia Department of Community Health is pleased to provide an opportunity to Georgia providers, provider associations, and other interested parties to meet the Georgia Care Management Organizations (CMOs).
Beginning July 1, 2017, CMOs serving Georgia Medicaid will include Amerigroup, CareSource, Peach State Health Plan, and WellCare. Come meet representatives from these CMOs on Friday, March 3, 2017at the Georgia Department of Community Health, 2 Peachtree St., NW, 5th FloorBoard Room, Atlanta, Georgia 30303
CLICK HERE for more information.
Healthcare in the News
These news clips were shared with GAMES by our state lobbyists, Southern Strategy Group:
Georgia House Approves Medical Marijuana Expansion
In a notoriously tough job, Grady chief survives and thrives
Determining Georgia's health care needs
Second CTCA hospital bill before Georgia lawmakers
More $$ for DME?
From VGM February 24, 2017
Updated Study Illustrates Value of DME within Health Care System
Leitten Consulting released its latest findings on the economic impact Medicare spending has on health care as it relates to durable medical equipment.
Leitten’s study, "The Case for Medicare Investment in Durable Medical Equipment,” shows that the health care system and beneficiaries save on long-term costs if the government invests in durable medical equipment services up front.
"This study continues to reaffirm the true value of DME within health care and the savings that it offers,” said John Gallagher, vice president of Government Relations for VGM Group, Inc. "DME providers have been able to save the health care system millions of dollars annually by taking care of patients in their homes.”
In the study, Leitten determined that for every dollar Medicare spends on durable medical equipment to beneficiaries, CMS could save from $11 to $29 in direct treatment payments. Overall annual savings range from $23 to $41 for every dollar invested in DME. The study also notes that since the 2014 update, "CMS has continued to expand its attacks on DME pricing, applying the pricing model to rural areas not covered by the earlier versions of the program. This has all led to a dramatic drop in DME providers serving the Medicare population, profit margins that are often thin or non-existent and reduced access to beneficiaries.”
CLICK HERE to read the white paper of the study.
Can we add Your Name Here?The 21st Century Cures Act instructed CMS to reprocess DME claims of those items that are included in competitive bidding items for the last 6 months of 2016, restoring the reimbursement rate to the rate as of January 1, 2016 in non-bid areas. CMS has directed the DME Macs to begin this process and providers will be receiving a refund this summer (if not sooner)
AAHomecare attorneys and experts considered the situation and determined this reprocess should also apply to Tricare as it’s rates are tied to (or pegged to) Medicare rates. You will have seen this letter in a previous News & Notes. To see Tricare response to date, CLICK HERE and scroll down to the heading "Tricare News"
GAMES has formed a small tasks force to consider how we might apply this same principal to other payors within our state that contractually base their fees off of Medicare rates. Please understand the association cannot discuss specific rates or individual contracts. CLICK HERE for the first of such letters that will be specifically targeted to Medicare Advantage plans operating within our state.
We are asking each GAMES member company to sign-on to this letter alongside the association. If you have not already done so, please CLICK HERE to email the association letting us know it is OK to include your company.
New DME Specialist
Martha Moore has joined the Georgia Department of Community Health as DME/O&P Program Specialist! She started on March 1st. You can CLICK HERE to email her to say welcome aboard! Or reach out by phone at (404) 657-9126.
Save These Dates!
Georgia Medicaid Fair
Tuesday, May 2
Cobb Energy Centre
GAMES Spring Meeting
Thursday, May 11, 2017
AAHomecare Washington Legislative Conference
May 24 - 25, 2017