Advocating on Your Behalf

$3.9 billion in federal legislative/regulatory wins since 2022, including:

• Successfully advocated for permanent 50/50 rate relief for rural area suppliers via legislative and regulatory action to safeguard the HME infrastructure and protect patient access, providing more than $2.3 billion to suppliers since 2022.

• Secured 75/25 relief for non-bid, non-rural areas through 2023 with an average 32% increase on the top 25 HCPCs codes, providing $280 million to account for the increased costs of providing care ($525 million since enacted).

• Carved out CRT power accessories from Competitive Bidding pricing, preventing the CRT community from inappropriately receiving $102 million in cuts since 2022.

• Secured a permanent fix for the oxygen "double dip" in reimbursement cuts that would have impacted all non-bid areas, saving O2 stakeholders $179 million since 2022.

• Prevented reimbursement cuts for DME that would have been triggered through the 2% Medicare Sequestration and across-the-board 4% Medicare PAYGO cuts, saving a combined $987 million since 2022.

$563.3 million in payer relations and state wins since 2022 in collaboration with state association partners, including:

• Secured several wins with major payers on HME policy issues including UHC, CareCentrix, BCBS, TRICARE, and more.

• Ensured TRICARE adopted CARES Act rates ($125 million).

• Implemented Medicaid rate floor protections across several states to prevent deep discounts off of the Medicare fee schedule ($120 million).

• Increased Medicaid rates across several states to ensure supplier viability and patient access ($75 million).

• Secured ARPA relief payments for HME in several states ($86 million).

• Achieved CRT state wins across multiple states ($16 million).

• AAHomecare's payer team also secured wins across numerous states that eliminated sales tax for certain HME/supplies, removed the capped rental of NIV, secured CPI-U adjustments, and more!

Our most recent regulatory wins include:

• Limit TPE reviews to only be for medical necessity so that suppliers don't fail a round for technical errors, thus improving the supplier experience and reducing the burden.

• Wait time for an ALJ hearing on average reduced from 4 years to 70 days.

• Expanded coverage for continuous glucose monitors (CGMs) and added coverage for power seat elevation.

• Allowed CPAP and RAD supplies to have a general description like "CPAP Mask" or "Mask - Fit to Comfort" on the Standard Written Order (SWO) so that suppliers don't have to get a new SWO for each change.

• Extended the timeframe for suppliers to contact beneficiaries for refills from 14 days to 30 days.

• Allowed CGM suppliers to bill every 90 days for 90-day shipments effective January 2024, reducing the burden on suppliers and patietns who were billed every 30-days for 90-day supply shipments.

• Clarified that the CR modifier can continue being appended on claims impacted by the PHE even if the initial claim was submitted prior to the PHE to ensure continued patient access.

• Created numerous Industry toolkits, white papers, and other resources to empower the HME community on key advocacy and operational initiatives, avialable in the Resource Library.

• Host dozens of educational webinars and presented at leading Industry events and state association meetings to educate the HME community on new policies/requirements, advocacy opportunties, and best practices. 

• Participate on the Medicare Education Advisory Board to shape the educational offerings at the conference.