FAHCS ADVOCACY WINS

FAHCS continued partnership with AAHomecare on many efforts once again pays off - ARPA Retroactive Relief of 19% Applies to Medicaid Claims from July 1, 2021 through June 30, 2022

~ AAHomecare reports
Florida’s Agency for Health Care Administration (ACHA) is granting one-time payments to providers of Home and Community-Based Services (HCBS), including DME, calculated as a 19% increase based on Medicaid payments made by the MMA (managed medical assistance) plans on a range of codes over July 1, 2021 through June 30, 2022.  The relief is possible thanks to the funding provided by the American Rescue Plan Act (ARPA), which went into effect April 1, 2021.

The payments do not require any application or reporting from eligible suppliers.  ACHA notes that “payments have been disbursed to the plans and the plans will then have 30 days to make disbursements to eligible providers.”

Last year, Florida granted relief to Provider Type (PT) 67 DME suppliers who provide services under the waiver programs in Florida. This round of relief is for PT 90 suppliers, which is essentially all DME providers.  The relief is based on billings for A,B,E,K, and T HCPC codes; L codes (O&P products) are not included in the calculations.

The win is particularly satisfying for Florida DME leaders who began working on a plan to seek a share of ARPA relief even before the funding mechanisms were finalized at the federal level.

“Florida is the first state AAHomecare began working with to seek ARPA-based relief,” said Laura Williard, AAHomecare vice president of payer relations [and FAHCS Board Member].  “On April 27, 2021 we sent a letter cobranded with FAHCS to the Governor’s office asking for a 20% retroactive increase based on one year’s claims.”

“Following the request, we continued to work with FAHCS leaders and their lobbyist, Tom Griffin, to build awareness and support for ARPA relief for DME suppliers with Florida policymakers, meeting regularly with AHCA officials and representatives from Governor DeSantis’ office,” added Williard. “Tom Wallace, AHCA deputy security for healthcare finance and data, deserves special recognition for understanding of the value DME delivers for all Florida residents and support during this effort.”

The ARPA relief follows on last month’s 7.5% Medicaid fee schedule increase for Florida DME suppliers, which goes into effect on October 1, 2023.

See more in Friday's Florida AHCA announcement and related FAQ document

Beth Bowen (FAHCS Executive Director) boasts, "FAHCS is very fortunate to have such a dedicated and hard-working advocacy team led by FAHCS Board Member, Laura Williard (AAHomecare) and Tom & Keaton Griffin (FAHCS Lobbyists).  Tireless efforts by the entire team over the last few years are finally paying off with this significant ARPA win and just last month, the 7.5% Medicaid fee schedule rate increase was confirmed and will take effect October 1, 2023."

You may have some questions regarding how this will be implemented and we will be providing more insight as we know it.