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Update On Indiana Medicaid Changes; Action Needed By Indiana Providers!

The following information is from the Great Lakes Home Medical Services Association eNews update, sent Dec, 15, 2020:
As previously reported, Indiana Medicaid (Indiana Family and Social Services Administration) is proposing drastic changes to the payment policies for HME, CRT, and medical supplies including rate reductions to the state’s LOWEST Medicare rate for CURES codes on 2/01/21 and remaining CURES codes on 8/01/22. Great Lakes joined other industry stakeholders in September to provide comments to FSSA on the proposed changes, however, as of press time, we’ve received no response to the comments nor to follow-up emails from the association urging continued dialogue on these issues. 
In mid-November, several Indiana legislators met with FSSA Secretary Jennifer Sullivan, MD, sharing their concerns and raising questions about the changes after being contacted by some of our members. A letter from HME stakeholders was sent to Secretary Sullivan as a follow-up to that meeting asking for her engagement on the issue given the severity of the cuts and the impact on the HME/CRT provider community and the Indiana Medicaid recipients they’re serving. Thank you to AAHomecare and VGM who continue to partner with Great Lakes on this important work. We recently learned that a group of legislators are working to get another meeting with Secretary Sullivan. Those officials include Sen. Jean Leising, Sen. Erin Houchin, Sen. Ron Grooms, Rep. Harold Slager and Rep. Steven Davisson. 
Action needed! We need other HME/CRT providers impacted by these Medicaid changes to contact their legislators in the Indiana House and Senate and do the following: 
Share concerns about the coming changes – details of core concerns are outlined in stakeholder comments and summarized below: 
  • Sustainability of Medicaid HME benefit – Great Lakes and HME advocates are willing to help the State make adjustments to rules and reimbursement to address budgetary and compliance issues but this needs to be done carefully, strategically and collaboratively to preserve beneficiary access; 
  • Medicare alignment is problematic – Medicaid and Medicare are fundamentally different programs serving distinctly different populations. Going to the LOWEST of Medicare rates of the three available in Indiana is disastrous not only harming the provider network but the patients served by the Medicaid program; 
  • Access to cost-effective, safe care at home – HME/CRT providers play a vital role in preventing hospitalizations and care in other acute settings in “normal” times; during a public health emergency, we are critically valuable with hospital census and spread reduction. Indiana lost 29% of HME providers in the past decade. Preserving access to a quality network of HME/CRT providers is crucial for public health and fiscal matters; 
  • Compliance with 21st Century Cures Act - The proposed changes are far too aggressive and go beyond Cures Act requirements. The State needs to be transparent and share data to assess and analyze what adjustments may be needed to meet the aggregate spend requirement of the federal law while preserving this important home-based benefit; 
  • Timeframe and review process – While we appreciate FSSA’s willingness to meet in the past, these are massive, intricate changes affecting hundreds of codes and complex policy and requires much more collaboration and time to make decisions and appropriate changes. This is especially difficult now as our members are working hard to care for patients during the pandemic with significant impact on staffing and resources. 
To find your state legislator, click here. Please share your concerns with the legislator. You can share the Sept. comments from the HME/Industry along with the summarized points above. If they share your concerns, ask them to connect with David Boyer, Sen. Leising’s legislative aide. If you have any questions or need assistance with your message, please contact Kam Yuricich in the Great Lakes office or Chuck Williams at Williams Bros. Health Care Pharmacy based in Indiana and Great Lakes President Elect.