AAH updates: Anthem, UnitedHealthcare, MACPAC
By HME News Staff
Updated Thu August 27, 2020
AAHomecare has doubled down on Anthem, sharing with the payer several examples of product cuts that highlight disparities between its new rates and Medicare rates both inside and outside competitive bidding areas, as well as the average rates currently in effect under the CARES Act. Earlier this summer, the association had expressed concerns about the cuts to Anthem, and the payer responded that the cuts “better align rates to state and local DME market dynamics.” In its subsequent response, AAHomecare also noted that “the DME marketplace is not the same as six months ago when you completed your rate analysis”…UnitedHealthcare has informed AAHomecare that a system issue has been fixed and that providers should now be able to get DMEPOS claims through the Uninsured Program. Earlier this year, the Department of Health and Human Services announced a new distribution of the Provider Relief Fund to allocate funds to providers treating uninsured patients during the public health emergency. Soon after the program opened on May 6, however, providers notified AAHomecare that claims were getting rejected…The Medicaid and CHIP Payment and Access Commission, a nonpartisan agency that provides recommendations to Congress, HHS and states, has sent a letter to HHS Secretary Alex Azar asking for considerable advance notice of when the PHE will end. The commission makes the case that because Medicaid/CHIP programs operate in alliance with federal and state governments, the flexibilities allowed by CMS during the PHE can't be just removed.
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