CMS fixes supplies denials
By HME News Staff
Updated 10:20 AM CST, Mon November 18, 2024
WASHINGTON – CMS recently implemented a fix for an incorrect edit denying claims for disposable medical supplies for Medicare beneficiaries if the date of service was the same as the discharge date from the home health agency claim, according to AAHomecare. For years, providers often received denials on their claims due to unreported open Part A home health episodes that were not visible when they checked beneficiary eligibility, and as a result, these providers have lost about $11.5 million per year, the association says. “This is an important first step in our engagement with CMS about suppliers’ challenges,” said Kim Brummett, senior vice president of regulatory affairs for AAHomecare. “While it addresses the issue of those who have the date of service as the same date of discharge from a home health agency, conversations continue with CMS to explore potential alternatives for suppliers to mitigate the losses and to know there is a potential home health episode open.” This issue was raised by a member in AAHomecare’s Woundcare Work Group and prompted a hybrid initiative of the Regulatory Council and Medical Supplies Council to, ultimately, engage CMS.
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