Webinar: "Navigating The New CMS Landscape: RADs, HMVs, and Supplier Survival" on June 25 at 1 p.m. CT.
Published in
Government Relations
on June 17, 2025
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.
Join industry experts Ronda Buhrmester, Kim Cuce’, Noel Neil, Zach Gantt, and Ray Gregg as they break down the key changes, explore the operational and financial impact on DME suppliers, and offer actionable strategies to navigate the new landscape. This session is essential for providers, billing teams, and clinicians working in the post-acute care space who need to stay ahead of regulatory shifts and ensure continuity of care for patients.
Key Takeaways
- Understand the new initial and continuing coverage criteria for RADs and HMVs
- Learn how to manage compliance and documentation under the new rule
- Explore the implications for hospital discharge planning and patient transitions
- Get tips for staff training, referral education, and revenue cycle adjustments
Sign up here to view the webinar on June 25.
Victory for NY Medicaid: NEMEP Secures 100% Rate Floor
HUGE WIN for NEMEP and NY Medicaid – 100% Rate Floor
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Posted by NEMEP on Friday, June 13, 2025
Yesterday, the New York Senate passed long-sought Medicaid rate floor legislation, S. 1616, on a unanimous vote. The State Assembly affirmed a companion bill (A2520) earlier in the week, also by a unanimous tally.
The bills require Medicaid managed care organizations (MCOs) to reimburse DME providers at no less than 100% of the state’s published Medicaid durable medical equipment and complex rehabilitation technology fee schedule. Currently, some MCOs reimburse DME providers at less than half of the Medicaid fee-for-service fee schedule for identical devices and supplies paid in the fee-for-service system.
“By providing parity, this will ensure access when beneficiaries transfer from one MCO plan to another and prevent multiple reimbursement rates for the same item and service,” said John Quinlan, President of the Northeast Medical Equipment Providers (NEMEP) and President of Quinlan's Home Medical. “Setting rate parity will help protect access to care for NY Medicaid beneficiaries and support NY businesses who provide these valuable services.”
“NEMEP, AAHomecare, VGM and other stakeholders advocated tirelessly for fair reimbursement that allows us to better support patients and reduce the time they spend in clinical or institutional settings,” continued Quinlan. “These sustained efforts ultimately paid off with unanimous support for rate floor legislation in both the Assembly and the Senate.”
“The New York DME community thanks Assemblymember John McDonald III and Senator Gustavo Rivera for their steadfast support and leadership in securing unanimous passage,” said David Chandler, NEMEP Board Member and AAHomecare Vice President of Payer Relations.
“I started working on this legislation with NEMEP leading up to its initial introduction in 2021, added Chandler. “We have gained momentum each legislative session since and have finally secured a big win that improves access to quality home-based care in New York state. The leaders at NEMEP deserve a lot of credit for their persistence in making the case for this policy though multiple sessions.”
New York Governor Kathy Hochul has until December 31st to sign the measure into law.
Beth Bowen, Executive Director adds, “NEMEP leadership has been tirelessly working toward this goal for years holding weekly lobbyist meetings with our solid team at Ostroff & Associates. Many trips to Albany pared with virtual sessions provided the advocacy we needed to set NEMEP providers up for success. A HUGE thank you to all who worked so hard to achieve this goal – it is apparent that with the unanimous vote, the lawmakers understand how important our industry is to the well-being of the beneficiaries in NY. We will update you when Governor Hochul signs into law!”