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CAMPS Events & Education


CAMPS 2013 Annual Convention
February 26-27, 2013
Hilton Irvine/Orange Co.
1880 MacArthur Blvd. Irvine, CA 92612

California HME Update
DHCS Announces Comment Period Medi-Cal by Report Claims Submissions

As a result of the signing of CAMPS sponsored legislation SB  728 (Negrete- McLeod) the requirement to submit a catalogue page from 2006 on claims submission for By Report  DME items for Medi-Cal  will be eliminated. DHCS has announced the opportunity for public comments on this change. CAMPS will submit a letter of support and if you would like to also submit comments you can see the details below. The comment period ends on 12/30/12.

Comment Forum to Open for Proposed Wheelchair Reimbursement Revision 

The public is invited to submit comment on a proposed revision to reimbursement policy regarding wheelchairs and wheelchair accessories. The proposed revision for reimbursement of "by report" wheelchairs and wheelchair accessories would require the submission of the manufacturer's purchase invoice (that includes the cost) and a copy of the manufacturer's current catalog page that lists the suggested retail price.

The 14-day Medi-Cal Comment Forum will open in the Newsroom area of the Medi-Cal website beginning December 16, 2012.

  

Comment Instructions
Comments can be submitted by email, mail or fax. Use caution when submitting confidential or sensitive information. Your email address will not be shared with any outside parties, but it may be used for future email notices from DHCS.

 

To submit via email, select the Medi-Cal Comment Forum page of the Medi-Cal website. The Web page's email links are categorized as "Provider," "Health Plan" and "General Public." To submit an email comment, click the associated link and submit your comments.

 

To submit via mail, use the address:

Public Comment Forum
DHCS Fiscal Intermediary
Attn: Publications Department
P.O. Box 13811
Sacramento, CA 95853

 

To submit via fax:
(916) 617-4021 - Attn: Publications Department

For comments to be processed, the following must be included in the email, fax or mail correspondence:

  • Name of submitter
  • Organization or affiliation
  • Telephone number

Health plans are encouraged to consolidate their comments and forward them through their designated contact person.

This forum is for the sole use of submitting comments about the proposal to revise the reimbursement policy regarding wheelchairs and wheelchair accessories. Unrelated comments or questions must be directed to one of the following phone numbers between 8 a.m. and 5 p.m., Monday through Friday, except holidays:

  • Providers, or those interested in becoming a provider: Telephone Service Center (TSC) at 1-800-541-5555
  • Beneficiaries can contact the Beneficiary Help Desk at (916) 636-1980

This comment forum will end December 30, 2012, at 5 p.m.

  
DHCD Announces Changes in Utilization Controls for Diabetic Test Strips and Lancets

CAMPS participated in a DHCS stakeholder meeting on their suggested changes to lower the utilization control quantity limits for diabetic test strips and lancets. This was part of the announced new MACs for diabetic tests strips on the Medi-Cal formulary effective 1/1/13. CAMPS joined with several pharmacist associations, American Diabetes Assoc. , manufacturer reps., and nurses from local diabetes clinics in raising the following concerns :

 

  • Though the MACs did not decrease significantly we know that the rebates from manufacturers to DHCS did likely increase. That will cause the margins on the difference between the MAC and what the provider acquires the products for to continue to shrink. Since providers receive a flat dispensing fee of $7.25 per prescription for dispensing diabetic supplies the ability to continue to dispense is jeopardized.
  • The UR limits of 150 strips per month for insulin dependent patients and 100 strips per 90 day period for non-insulin dependent patients  are too low and will increase the burden on providers to TAR for the excess quantities.

As a result of the stakeholder discussion DHCS only made a minor change to the proposal. They recognized that the frequency of testing for women with gestational diabetes will be higher. They altered the quantity limits for patients diagnosed with gestational patients treated with or without insulin injections was increased 150 strips and 200 lancets per month. DHCS claims that the other UR guidelines are consistent with Medicare and other organization's testing frequencies and that a patient with greater needs can get those quantities by providing medical justification via the TAR process.

 

CAMPS will continue to advocate that these UR limits to be increased to seek modifications prior to the 1/1/13 effective date.  

  
Support H.R. 6490 - Spread the Word

The American Association of Homecare has provided the following information to recruit support for H.R. 6490. Please read carefully and do what you can to help get this law that is so important to our industry passed!

 

Over the next couple of weeks, the homecare community must get more members of Congress to support H.R. 6490, the bipartisan bill to replace the current bidding program with the far-better market pricing program (MPP).

Senators and Representatives need to hear that providers and consumers across the U.S. strongly support this important bill, which currently has 31 cosponsors.  Four new backers were added to the cosponsor list this week:
 

  • Rep. Bill Posey (R-Fla.)
  • Rep. Dennis Ross (R-Fla.)
  • Rep. Heath Shuler (D-N.C.)
  • Rep. Ed Whitfield (R-Ky.)

 
 
But now we need to expand those efforts as widely as possible. 

Please spread the word about the importance of getting Congress to make this important change to Medicare policy to preserve access to home medical equipment and care.

 

As we push for H.R. 6490, we must show there is the same degree of enthusiasm for that bill as the bidding repeal bill, H.R. 1041, which has more than 170 cosponsors and bipartisan support.  
 

Homecare providers, patients, and family members have the strongest case to make to their home-state lawmakers.  

  

The battle to get MPP enacted into law has two parts:
 
(1) Homecare companies and everyone who benefits from homecare must convince Congress that the current bidding system is unsustainable and is seriously undermining how Medicare beneficiaries obtain homecare;
 
(2) When enough members of Congress realize there is a significant problem with the present system, the MPP alternative becomes a ready-made solution and arguments for MPP are easier to make.  
   
"If it ain't broke, don't fix it," is the position of CMS and their allies.  We must push back against that flimsy and inaccurate assessment.  You are the best advocates to make the point that the current system is not working.

Let's turn up the heat through meetings with members of Congress, phone calls to their Capitol Hill and the district offices, and emails to lawmakers' staff.   
 
Use this Action Center to send an email message to your Senators and your Representative.  You can also find telephone contact information for your legislators here

 

 
There is much to do here in Washington as we fight to get this legislation enacted. AAHomecare is working closely with the lead sponsor of the bill, Rep. Tom Price, MD (R-Ga.) and the key committees in the House and Senate. 
 
We continue close work with other homecare stakeholders - such as consumer groups and the clinical community - to enlist their support and advocacy for H.R. 6490 and MPP.
 
We thank everyone who has pushed hard to inform lawmakers about the problems with the current bidding program and need for a replacement. Your efforts have been critical.
 

  
SAVE THE DATE

 

CAMPS 2013 Annual Convention

February 26-27, 2013

Hilton Irvine/Orange County

1800 MacArthur Blvd.

Irvine, CA 92612

 

Additional Information Coming Soon!

  




One Capitol Mall, Suite 320
Sacramento, CA 95814 
t: (916) 443-2115 
f: (916) 444-7462