Skip to main content

VGM & ASSOCIATESHealthcare MSO

Search GO

Search GO

VGM & ASSOCIATESHealthcare MSO LEARN ABOUT VGM

VGM Meets with CMS to Discuss Concerns Related to Post-PHE

Published in Government Relations on March 28, 2022

VGM Government Relations recently met with CMS to discuss concerns about supplier requirements once the public health emergency (PHE) comes to an end.

We heard your concerns related to policy requirements and expectations after the PHE comes to an end and brought those to the attention of Provider Compliance Group for CMS’ Program Integrity. The discussion included a number of topics including providing plenty of notice (60 to 90 days) to the healthcare industry in preparation prior to the end of the PHE.

In addition, the discussion included concerns for the patients that are currently renting DME under the PHE waivers. Will these patients need to get qualified to meet policy coverage criteria, or will these patients fall under the grandfather method? While CMS representatives could not provide details, there was agreement that disruption of equipment use, medical necessity, and reimbursement should not occur for the patients and the suppliers.

Amongst the discussion, VGM’s Ronda Buhrmester and U.S. Rehab’s Dan Fedor raised concerns related to audits. With the various contractors that audit CMS claims, it was important that CMS is aware of the scrutiny that tends to fall on the DME suppliers. The claims using a PHE waiver (using the CR modifier and COVID-19 claim narrative) are a big concern for suppliers. The suppliers were also on the front lines collaborating with hospitals, nursing facilities, and physician clinics offering services to keep patients safe in their homes using home medical equipment.

While there were several topics of discussion related to policies and audits for post PHE, VGM’s Mark Higley provided data-related increases in staffing/wages, as well as acquisition costs.

The CMS staff appreciated the informative conversation with VGM, and are looking forward to future communications between both parties.

TAGS

From Our Experts

Evaluating the Value of a Payer Contract thumbnail

Evaluating the Value of a Payer Contract In our last article, Key Payers Denied Your Application Citing Their Network Is Closed – Now What?, we discussed strategies for addressing payer contracting denials due to a closed network. As indicated, this process can be an extremely time-consuming exercise with no guarantees and mixed results. Below are a few things to consider as you evaluate whether a contract is worth the extra effort.

Webinar: "Navigating The New CMS Landscape: RADs, HMVs, and Supplier Survival" on June 25 at 1 p.m. CT. The Centers for Medicare & Medicaid Services (CMS) has released its final National Coverage Determination (NCD) for RADs and HMVs used in treating chronic respiratory failure due to COPD. While the rule potentially expands access to bilevel ST therapy (RADs), it also introduces complex compliance requirements, tighter usage criteria, and increased documentation burdens—without additional reimbursement.

The Return of Competitive Bidding thumbnail

The Return of Competitive Bidding The Centers for Medicare & Medicaid Services (CMS) appear to be laying the groundwork for another round of the Competitive Bidding Program (CBP). While full implementation will take a couple of years, an official announcement is expected this summer—potentially as early as July.

Out With The Old RAC, In With The New thumbnail

Out With The Old RAC, In With The New On April 28, 2025, CMS awarded Cotiviti GOV Services LLC, the new RAC Recovery Audit Contractor (RAC) Region 3, 4, and 5 contracts. RAC Region 3 includes the following Medicare Administrative Contractor (MAC) jurisdictions: JJ, JM, and JN. RAC Region 4 includes jurisdictions: JE, JF, and JL. And RAC Region 5 includes jurisdictions: JA, JB, JC, JD, as well as the HH/H MACs: J6, J15, JK, and JM.

Iowa Leads the Charge! All Four Representatives Back H.R. 2005—Will Your State Step Up? thumbnail

Iowa Leads the Charge! All Four Representatives Back H.R. 2005—Will Your State Step Up? At VGM Group, Inc. we have the pleasure of serving our members and partners throughout the country.  One of the many ways we do this is through legislative advocacy, working with our partners to create a more equitable and effective healthcare system. All our VGM units are dedicated to advancing our partners' businesses, streamlining operations, and working every day to enhance reimbursement for the quality in-home healthcare our industry provides all people.

Mike Hamilton Of ADMEA Honored With The Mal Mixon Advocate Award thumbnail

Mike Hamilton Of ADMEA Honored With The Mal Mixon Advocate Award Last week, during the 2025 AAHomecare Washington Legislative Conference, Mike Hamilton, Executive Director of ADMEA, was honored with the prestigious Mal Mixon Advocate Award.

VGM Senior Leaders Engage in Advocacy at AAHomecare Legislative Conference thumbnail

VGM Senior Leaders Engage in Advocacy at AAHomecare Legislative Conference This week, VGM leaders attended the AAHomecare Legislative Conference in Washington, D.C., a premier event dedicated to advancing healthcare policy and advocacy. AAHomecare provided attendees with valuable insights, equipping them with key discussion points and strategies for effective meetings with legislators.

Champion of Change: Paula Vineyard of Elana Health & Loop Medical Leads Healthcare Advocacy in West Virginia thumbnail

Champion of Change: Paula Vineyard of Elana Health & Loop Medical Leads Healthcare Advocacy in West Virginia On Thursday, May 8, Paula Vineyard, owner of Elana Health & Loop Medical, took a pivotal step in healthcare advocacy by hosting a meeting with Tyler Ohrn, Field Representative for Congresswoman Carol Miller of West Virginia's First District. The hour-long discussion centered on the pressing need for congressional support of H.R. 2005.

Unlock everything you need to successfully run your business.

Become a Member