AAHomecare gets to work on Medicaid reimbursement

WASHINGTON – AAHomecare’s Payer Relations Team has begun a nationwide campaign to work with state/regional association leaders to better align state Medicaid rates with higher costs. 

The association says HME providers are experiencing increasing product prices and operational costs due to the COVID-19 pandemic and supply chain issues, as well as ongoing inflation pressures. 

“Our work will include requesting that rates reflect the 6.4%+ CPI-U increases granted by CMS, as well as additional adjustments based on rising costs specifically facing HME suppliers in the state,” AAHomecare stated in a bulletin. “This effort can be undertaken in all states, not just the 30 states that currently follow Medicare rates.” 

Many states aligned their rates with Medicare’s in the wake of Congress passing the CURES Act in 2018. Some of these rates are pegged to the lowest Medicare rate found in the state, some are tied to non-competitive bidding area/non-rural rates, and some follow 50/50 blended rural rates for the state, AAHomecare says.  

Because rate adjustments will require legislation in some states, the association is working to address the issue in budget bills. In Florida, for example, the state Medicaid program has included a 5% DMEPOS increase in its budget request. 

“Other states where we have recently joined association leaders in meeting with Medicaid officials on reimbursements include Georgia, Kentucky, North Carolina, Oregon, Tennessee, and Virginia,” AAHomecare stated. “We are also looking at opportunities to introduce Medicaid rate floor legislation in several states.” 

AAHomecare has developed a letter that stakeholders can use to discuss rate adjustments with Medicaid authorities. 

• Read AAHomecare’s analysis of the new Medicare fee schedule here.