CAMPS has testified before both the Assembly and Senate Budget sub-committees requesting that there be statutory changes how Medi-Cal reimburses for DME.  Current law requires that Medi-Cal reimburse DME items at either 80% of the comparable Medicare rate for most DME and 100% of Medicare for custom rehab equipment and accessories. In addition, due to provider rate reductions from 2011 those rates were further reduced by 10%.

 

DHCS has filed a State Plan Amendment that would change reimbursement to be 80 or 100% of the Medicare non-rural rates that would utilize the much lower Medicare CB rates. If the SPA were to be approved by CMS later this year it would then be applied retroactively to 1/1/19. You can go to   www.campsone..org  to see all the details and guide you in reaching out to key legislators to ask them to provide our requested relief. Other organizations like the Ca. Children's Hospital Assoc. , the Children's Specialty Care Coalition, Western Center on Law and Poverty are in support of our budget change requests. Those requests are;

 

 

Please act now and support the efforts of CAMPS is stopping these disastrous reductions. CAMPS also testified last week in support of AB 719 ( Diep) that would repeal the 10% provider rate cut for all Medi-Cal providers. AB 719 passed the Assembly Health Committee and the repeal is also being proposed in the Budget sub-committee process.

We had heard from a member about a recent rash of denials indicating RAD0155 - The prescribing/referring provider number is missing or invalid. The physicians in question were registered in the Medicare PECOS system , which is an alternative for Medi-Cal compliance. In addition the edit for this item was not supposed to be in effect. We reached out to Conduent and DHCS and were told that the error was recognized and corrected on April 12th . There will be an Electronic Payment Correction performed to reprocess those denials but the timing is uncertain. We would suggest that any impacted providers simply resubmit those claims.

We're excited to announce that for the second year in a row we have partnered with HME News to offer ONE benchmarking survey for the HME industry.

With this partnership, we hope to make participating more convenient, and we anticipate an increased number of submissions, which will result in a more accurate picture of the HME industry.   The survey is open now through Wednesday, July 17. By completing the benchmarking survey, you will have FREE access to the results once the report is complete. And, if you take the survey  before May 31, you will automatically be enrolled for a chance to win a   FREE registration to the VGM Heartland Conference. 

We look forward to your participation!

 

CAMPS has sponsored SB 624 ( Wilk) which would provide relief to medical supply and DME providers who due to delays in Medi-Cal altering reimbursement were unable to recoup overpayments of sales tax on medical supplies and equipment.

 

SB 624 would rectify that injustice by allowing an impacted provider of DME or medical supplies to seek a refund of the excess sales tax payment. It would create the ability to file such a request and require stakeholders to work in collaboration with CDTFA staff to develop the necessary documentation for claim submission.  The Department of Health Care Services would also provide the specific amount due to each qualified provider.

 

SB 624 would provide a period of time starting in March 2020 for any impacted provider to submit a request for a refund. Based upon amendments taken in the Senate Governance and Finance Committee the funds available would be limited to $1 million. If requests for refunds exceeded that amount that all requests would be prorated. The bill passed on a unanimous vote of 7-0 and now moves to the Senate Appropriations Committee.