State news: Massachusetts, Pennsylvania

BOSTON – The MassHealth Medicaid program is implementing a 10% rate increase for DME claims with dates of service effective July 1, 2021.   

It's also implementing a 50% increase for labor code K0739, which covers repair or nonroutine service for DME other than oxygen equipment requiring a skilled technician. 

“This is a big win when we needed it most,” said Jason Morin, president & CEO of HOMES. “Between the pandemic impacts and the recent respiratory recall, providers are reeling and struggling to find ways to continue to absorb these rising costs. This action provides much-needed direct relief to the providers of Massachusetts and also shows us that the state’s Medicaid leadership is listening.” 

MCO legislation introduced in Pennsylvania 

Republican state Rep. Tommy Sankey has introduced a bill in the Pennsylvania House of Representatives that seeks to prevent self-referrals by managed care organizations. 

The legislation, HB 1726, would amend the state’s Human Services Code as follows: 

“Section 1419. Managed Care Plan Prohibition – Notwithstanding any other provision of law, a managed care plan [MCO definition language] may not refer or enter into a subcontract arrangement to provide services defined and specified in the managed care plan contracts with an entity where the entity or managed care plan may self-refer for durable medical equipment and supply services.” 

AAHomecare has worked with PAMS to build support for the legislation. 

AAHomecare encourages HME suppliers and other stakeholders in Pennsylvania to reach out to their state representatives in support of the measure through this Action Center.