Stakeholders Try to ‘Take Control' of Repair Issues

Published in Complex Rehab on August 10, 2023

HME NewsThis article was originally featured in HME News.

Stakeholders now have four specific asks, including reimbursement reform, for state Medicaid programs and other payers to increase access to repairs for wheelchairs. 

“No. 1, you need to get paid for your travel and for your diagnosis time for repairs,” said Wayne Grau, executive director of NCART, during a recent industry webinar. “When I brought this up in two meetings I had with legislators – when I told them we don’t get paid for travel or diagnosis – they thought I was kidding. One of them laughed. I said, ‘I’m not kidding,’ and he said, ‘Well that’s dumb.’ I was like, ‘Yeah, that’s what we’re saying.’” 

Stakeholders have ramped up efforts to address issues with repairs in the wake of right-to-repair bills popping up in states across the country, led by Colorado

Also, stakeholders are advocating for eliminating prior authorization and prescription requirements for repairs – “You guys should be able to go out there and fix that product the day you get the call,” Grau said – and reimbursing for preventative maintenance. The latter is the focus of a bill currently working its way through the Pennsylvania state legislature. 

“I don’t understand why we don’t have preventative maintenance,” he said. “We want to identify issues before they become emergencies.” 

Lastly, stakeholders are advocating for requiring providers to “service what they sell,” Grau said. 

“All you folks out there have made (huge) investments into your business infrastructure, so it’s not fair if a person just decides to sell equipment and then says, ‘No, I don’t do the repair, you need to go to the rehab company down the street,’” he said. “That is wrong.” 

Stakeholders, including regional HME associations, VGM and AAHomecare, are currently advocating for these asks at the same time as they are fighting right-to-repair bills in multiple states, including Tennessee, California, Iowa and Massachusetts. 

“That’s going to be a big focus for 2024 is to get our language in there,” Grau said. “Why is that so important? Because we want to really control how things are being done. We also want to present real reform and solutions to the problem, not something that just looks good on paper.”


TAGS

  1. billing & reimbursement
  2. complex rehab
  3. reimbursement
  4. repairs

From Our Experts

We're Not Gonna Take It Anymore thumbnail We're Not Gonna Take It Anymore What choices do we have as an industry tied to insurance contracts and CMS requirements for maintaining billing privileges? Heartland 2025: e-Prospectus and Schedule Now Available! thumbnail Heartland 2025: e-Prospectus and Schedule Now Available! We're excited to unveil the features planned for Heartland 2025, including industry-leading education and unlimited networking opportunities. Forecasting Insights for 2025: A Promise for True Transformation thumbnail Forecasting Insights for 2025: A Promise for True Transformation From technological advancements to evolving patient needs and wants, the landscape in the next 24 to 36 months continues to shift in ways that promise both challenges and opportunities. Navigating the Future: Essential Cybersecurity Insights from a CISO thumbnail Navigating the Future: Essential Cybersecurity Insights from a CISO The HME and DME industry is evolving rapidly, driven by technological advancements, regulatory changes, and shifting market dynamics. Cindi Petito on Bridging Gap Between CRT and Access thumbnail Cindi Petito on Bridging Gap Between CRT and Access Cindi Petito brings her extensive experience in CRT and home access industries to VGM & Associates to advocate for a holistic approach to in-home services. U.S. Rehab Offers Live Tech Training and New ATP Training in 2025 thumbnail U.S. Rehab Offers Live Tech Training and New ATP Training in 2025 U.S. Rehab is excited to host in-person live Tech Training sessions and ATP Gateway Training in 2025. U.S. Rehab Introduces ATP Academy to Train Future ATPs thumbnail U.S. Rehab Introduces ATP Academy to Train Future ATPs The ATP Academy is designed to help rehab technicians advance their careers by becoming certified Assistive Technology Professionals (ATPs). VGM Heartland Conference Announces Website Redesign thumbnail VGM Heartland Conference Announces Website Redesign VGM is excited to unveil its newly redesigned website. Refreshed and enhanced for a more user-friendly experience, the updated site follows a more streamlined process, making all resources and information about the VGM Heartland Conference easily accessible.