DHCS had scheduled a webinar last week to update providers on the status of Medi-Cal Rx implementation. That was cancelled and there is no new information available as to status or timeline.
Medi-Cal SPA / Increased Reimbursement Rates for Respiratory Equipment and Supplies
We are still awaiting implementation notice on these important increase for rates of reimbursement of the Medi-Cal Fee for services of respiratory equipment and supplies. Those changes include:
Increase the Medi-Cal Fee for services reimbursement rates on respiratory equipment and supplies from 80 to 100% of Medicare rural rates effective until the end of the Public Health Epidemic (PHE), likely end of 2021. Those rates will also be retroactive to the start of the PHE, March 2020.
They will also eliminate the additional 10% cut on respiratory equipment and supplies
We have been told that the rate changes are imminent but have yet to see them announced. We know that doing an Electronic Payment Correction (EPC) to reprocess prior claims paid going back to March 1, 2020 will also not be done for months. We will alert you when the rates are changed.
CRT Reform Bill Held in Senate
SB 717 (Dodd) would update the current Medi-Cal CRT standards and incorporate current definitions of services and the need for qualified professionals to perform those assessments. The bill was sponsored by NCART and is supported by CAMPS. SB 717 would also eliminate the current 10% provider rate cut that has existed since 2009 on CRT.
SB 717 passed the Senate Health Committee on a unanimous vote and also passed the Senate Appropriations Committee but with an amendment. The amendment removed the elimination of the 10% cut and required any such change to be contained in the Budget Act. The bill then went to the Senate floor but will not be heard this year due to a limitation on legislators only pursuing 12 bills. SB 717 was a casualty of that process and is now a two year bill meaning it can only move next year. There is a continued effort to get the 10% cut eliminated for CRT in the current budget deliberations but prospects are not good.
New Bill Mandates Additional Hazard Pay for
Health Care Workers
AB 650 (Muratsuchi) would require a wide variety of health care providers, including DME/Medical supply providers, to provide hazard premium pay to their workers retroactive to 1/1/21. It would only apply to health care entities with 100 or more employees so it would not apply to all provider entities. Originally the bill required a $5 an hour premium payment but that was changed to a quarterly bonus payment of $2,500 that would start in 2022 and be applicable to workers who were employed during the pandemic 2020-2021. It is now labeled a employee retention bonus.
CAMPS has joined a coalition of provider entities to oppose AB 650. It would have a devastating effect on many providers who have already struggled with increased costs of providing equipment and services during the PHE. Provider reimbursement has not been increased to account for those costs and no one had assumed this new expense could be imposed. AB 650 is currently awaiting a vote on the Assembly Floor.
Recent amendments would provide a credit against any bonus previously paid by an employer, expand the bonus to government entities, and sunset the bill on 12/31/23. There are significant costs for the Medi-Cal program since in reimbursing SNFs Medi-Cal must include the costs to the facility of any state or federal mandates. The costs is estimated at $924M.
SB 605 (Eggman) - Right to Repair Medical Equipment
CAMPS has been part of a coalition opposing SB 605 regarding the ability of independent repair facilities to repair medical equipment including DME. It is part of a national effort to require that manufacturers of medical equipment be required to provide parts, schematics and information to other then factory authorized technicians and to do so at “reasonable cost.” Manufacturers could still have approved or certified repair technicians but they must also offer that opportunity to others. The sponsors claim a shortage of certified technicians, higher costs and delays in repairs.
At its first hearing SB 605 was amended to only apply to medical equipment in hospitals and it did have the support of the hospital association. It did pass the Senate Health Committee but was eventually held in the Senate Appropriations Committee and will not move any further this year.
