CAMPS State Legislative Efforts Pay Off!

Published in Government Relations on July 06, 2022

Last week, the final budget deal was announced and approved by both Houses today. CAMPS pursued multiple reimbursement changes and following reimbursement changes will occur:

• Makes permanent the 100% of Medicare for all respiratory equipment and supplies that was established by DHCS during the PHE.
• Eliminates the 10% cut on all DME.
• Eliminates the 10% cut for Continuous Glucose Monitoring devices.
• Eliminates the 10% for orthotic devices on 7/1/22 or when federal approval is obtained. Eliminates it for prosthetic services/devices on 1/1/23.

Craig Douglas, VGMs VP of Payer Relations reports, “The positive outcome achieved for our industry outlined herein is a prime example of what we can achieve when we identify a common goal, put our collective voices together, and initiate the necessary conversations with the people who can help us achieve our desired outcomes. When we find ourselves in situations where something is not reflective of our current environment, whether that is a medical policy, a reimbursement rate, etc,, regardless of how long that policy or rate has been in place, we need to point out the insufficiency and work together towards a better outcome. This is exactly what CAMPS did in this situation, working in conjunction with many of their members and other industry stakeholders to accomplish a better outcome.”

Congratulations to CAMPS and all HME suppliers in California for these significant changes! This is how working together as a state association can accomplish positives for all in the industry! If you are not apart of CAMPS or your state association, you need to consider joining.

As posted by CAMPS (California Association of Medical Equipment Product Suppliers)

Final Action on State Budget and
Medi-Cal Changes that Impact You:

Earlier this week the final budget deal was announced and approved by both Houses today. CAMPS pursued multiple reimbursement changes including;

• Elimination of the current Medi-Cal 10% cut for all DME, Medical supplies and enteral formula
• Make reimbursement for all DME at 100% of the Medicare rural rate

The Legislature’s version of the budget did in include the elimination of the 10% for all providers/services and 100% of the Medicare rural rate for all respiratory equipment and supplies. Then the final negotiations between Legislative leadership and the Governor occurred behind closed doors to resolve any differences. Unfortunately, the Governor/ Administration did want to provide relief for all providers/services based upon the ongoing fiscal impact and instead expanded the relief to limited provider types. The budget trailer bills AB 184/ SB 184 are the vehicles for the Medi-Cal provisions and were passed today.

It is a mixed bag for us but there is progress and long term benefits, but obviously more to do. The elements of change for us are as follows:

• Makes permanent the 100% of Medicare for all respiratory equipment and supplies that was established by DHCS during the PHE. We assume it is the Medicare rural rate but will await final announcement. The rural rate is used now and continues during the PHE status which has not changed.
• Eliminates the 10% cut on all DME. That is an expansion over the Governor’s May Revise which only exempted respiratory equipment and supplies. It does not exempt medical supplies or enteral formula. The elimination of the 10% cut will occur either on 7/1/22 or when CMS approval is provided, whichever is later.
• Eliminates the 10% cut for Continuous Glucose Monitoring devices.
• Eliminates the 10% for orthotic devices on 7/1/22 or when federal approval is obtained. Eliminates it for prosthetic services/devices on 1/1/23.

We will notify you of the effective dates once it is clear. We accomplished much this budget cycle but will continue to pursue relief for medical supplies and enteral formula.

TAGS

1. billing & reimbursement
2. medicare
3. reimbursement
4. state association