WASHINGTON, D.C. (July 30, 2021)—The American Association for Homecare’s (AAHomecare) payer relations team has been working with leaders at state and regional associations to direct relief from the March 2021 American Rescue Plan Act (ARPA) to the home medical equipment (HME) community. Those efforts bore their first fruit last week when MassHealth included a 10% Medicaid rate hike for HME as part of their plans to allocate Massachusetts’ share of the funds.
Support for health care providers ensconced in ARPA is available through two separate avenues. The legislation provides $195 billion to states to mitigate economic harm related to the pandemic. The legislation also increases the federal medical assistance percentage (FMAP) for certain home and community-based services (HBCS) by 10%.
AAHomecare developed materials to explain these programs and sample language to request that HME be included in these services for leaders in individual states to share with Medicaid authorities and other government officials. In early May, AAHomecare also enlisted a health care consulting firm with specialized expertise in Medicaid policy to analyze the legislation and engage the Centers for Medicare & Medicaid Services (CMS) to ensure that HME expenditures were acknowledged as being eligible for the FMAP increases. By late June, CMS officials were affirming that states could use funds attributable to the increased FMAP to support HME providers.
The legislation also included a provision that states would not be eligible for the additional FMAP funding if they decreased Medicaid reimbursements below the rates in effect on April 1, 2021. AAHomecare recently highlighted that fact in testimony against proposed cuts before the Texas Medicaid Commission and will remind other states considering decreases as needed.
States have flexibility of how they apply their share of the $195 billion grant to mitigate the impacts of the pandemic. In the sample request letters the association developed in concert with state leaders for those funds, it suggested a one-time payment to HME providers of 10% of their DMEPOS Medicaid billing for dates of service between March 6, 2020, and April 30, 2021.
For requests related to the FMAP-related tranche, materials highlighted that states could utilize the additional funding for:
- Broad-based relief for all HME suppliers based on their Medicaid billings.
- Coverage for HME suppliers sending certified or registered therapists into the home.
- Coverage for remote patient monitoring, telehealth and PAP compliance tracking.
- Coverage for Assistive Technology Professional services provided in concert with CRT products.
- Coverage for seat elevation systems and power standing systems.
- Expand/develop coverage for glucose monitoring.
- Reimbursement for personal protective equipment used by HME suppliers.
“With such extensive relief potentially available, it’s been critically important to make sure that state leaders are equipped to make an effective case for garnering a share for HME suppliers,” said Laura Williard, AAHomecare vice president of payer relations. “I appreciate the terrific support from the suppliers and association executives who have been a part of developing our approach and sample request language for states to use.”
Williard and David Chandler, senior director of payer relations, have worked directly with association leaders in numerous states to fine-tune their requests. There are currently 26 states who have requested these funds.
“Additional relief is critically needed by HME suppliers who are dealing with increased costs thanks to staffing shortages and higher product prices, especially for PPE,” said Barb Stockert, who serves as executive director for the Pacific Association for Medical Equipment Services (PAMES) and for the Big Sky Association of Medical Equipment Suppliers. “Laura and David have done an amazing job educating state leaders about the process and helping us put together request letters to governors, state legislators, and other state healthcare officials.”
PAMES and Big Sky ultimately submitted relief requests for HME for both the $195 billion tranche of funds and the FMAP funding for Idaho, Montana, Oregon, Washington and Wyoming.
The deadline for requests for funding tied to the FMAP program is closed, but some states have put in additional timeframes to allow for additional asks or to supply more details for requests.
States are using varying approaches to determine how ARPA relief is distributed. Some will be handled through state legislatures, others driven by governors’ offices, and committees appointed by a governor will lead the process in some instances. The AAHomecare Payer Relations team looks forward to working with HME stakeholders to support their requests with additional outreach to secure a share of these funds.
“State association leaders have built solid relationships with Medicaid officials and strengthened awareness of the role that high-quality HME plays in protecting seniors and vulnerable patient populations in their states,” added Williard. “It’s heartening to see that recognition pay off in Massachusetts. Now we need to make sure governors, state legislators, and health officials who are distributing these funds are aware of the important precedent that’s been set there and bring home more relief for HME.”
Visit aahomecare.org for more information.
