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| July 09, 2024 |
AAHomecare Opens Survey on Impact of Medicare CutsResponses Due Friday, July 19AAHomecare is conducting a nationwide survey on the impact of the expired Medicare fee-for-service 75/25 blended rate for non-bid/non-rural areas on the HME community and Medicare patients’ access to medically necessary equipment. The survey is open through Friday, July 19. All HME suppliers who serve patients in non-rural/non-bid areas are encouraged to participate. Your responses will provide data to help HME advocates make the case on Capitol Hill and with CMS for extending 75/25 rates that were rescinded on January 1, 2024. Take the survey here. Click here for the full AAHomecare announcement. Contact Stephanie Legree at stephaniel@aahomecare.org with any questions. Ohio Medicaid Oxygen Rule in Clearance for Public CommentComment Period Open July 9-16OAMES has been working with the Ohio Department of Medicaid Non-Institutional Policy staff on the review of several DMEPOS rules in the Ohio Administrative chapter 5160-10. Today, ODM posted a draft of the proposed oxygen rule 5160-10-13 and CMN which are open for comment from 7/09/24 to 7/16/24. At this juncture, these are rules that Ohio Medicaid staff are drafting and editing but have not yet been formally proposed for adoption. This step offers an opportunity for affected organizations and individuals to provide input. The Clearance notice provides a summary of key changes along with a copy of the proposed rule and CMN. OAMES appreciates working with ODM Policy to make a number of positive changes discussed over the past year. A targeted effective date is 10/01/24 which will be confirmed later in the regulatory review process. If you have any concerns about the proposed rule, please contact Heidi Moss in the OAMES office. If you’d like to submit comments, please email ODM at Rules@Medicaid.Ohio.gov. Watch for updates in the coming weeks including the official filing of the rule and a future public hearing date. OAMES Monitoring ODM’s Latest PNM ImplementationBack from the holiday celebration and catching up? We want to make sure members who serve Medicaid recipients have seen recent ebulletins from OAMES offering guidance on the June 30th Ohio Department of Medicaid’s (ODM) implementation of the latest phase of the Provider Network Management (PNM) module with “new features” in the new Ohio Medicaid Enterprise System (OMES). Be sure to review OAMES 6/27/24 ebulletin and 7/03/24 ebulletin for the latest information, steps to report and track issues, and other ODM guidance and resources. OAMES is continuing to monitor information from ODM and OAMES members on this transition. We’ve shared concerns with ODM that the connectivity issue is still a problem one week after launch. The “Important Alert” banner remains posted on the ODM PNM website stating they are working to resolve the problem “as quicky as possible”. We know this is causing serious delays in claims processing for all healthcare providers including OAMES members, so we’ll continue to monitor and press for resolution. Some of OAMES members focused on CRT services have reported numerous prior authorization (PA) issues. We urge members to continue reporting problems to the ODM Integrated Helpdesk (IHD) – they are available by phone at 800-686-1516 or via email at IHD@medicaid.ohio.gov. OAMES has elevated one specific PA issue to the Medicaid Policy team related to coverage for fee-for-service recipients in long term care facilities. Two OAMES members have reported that after discussing the issue with ODM’s tech support, they’ve been told that the system is working as intended indicating that certain HCPCS codes are “reimbursable through the facility’s cost report” so we’ve reached out to Policy for assistance and will keep members updated as we learn more. The latest ODM Press was published 7/05/24 which included an article on PA errors in the PNM module. Click here to view. Members are reminded to subscribe to the ODM Press if you aren’t already. OAMES will continue monitoring the PNM implementation and share any further guidance and developments from ODM via OAMES ebulletins. Medicare Article on Treating Practitioner EvaluationThe Region B Council passed along an informative article published 7/03/24 by CGS, “Treating Practitioner Evaluation of the Blood Gas Study for Oxygen”, that's of interest to those providing oxygen to Medicare recipients. The Oxygen and Oxygen Equipment Local Coverage Determination (LCD) (L33797) requires that “The treating practitioner has … evaluated the results of a qualifying blood gas study performed at the time of need.” The DME MACs have received a lot of inquiries regarding how this information may be documented to satisfy the requirements and developed this article to offer important guidance to providers. CGS Administrators Line-Up of July DME Training WebinarsCGS DME Provider Outreach and Education team regularly hosts live webinars to offer training for providers and the July schedule is busy! Check out the following list of webinars, including a three-part series on Documentation Requirements, offered through the end of the month. Details and registration available here!
Be sure to review their step-by-step guide for information on how to register, attend, and download presentations in their webinar platform. |
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