Latest News

Congress Must Support Prior Authorization Process for Durable Medical Equipment Under the Medicare Program—H.R. 2445

Medicare audit contractors and their impact on beneficiary care has reached a boiling point. The Center for Medicare Advocacy (CMA) has filed a class action lawsuit against Health and Human Services (HHS) over the first two levels of the Medicare appeals system, which the Center alleges "rubber stamp" coverage denials at both the Redetermination and Reconsideration levels of appeals. CMA brought the suit against HHS just weeks after the American Hospital Association also sued HHS over the backlog at the third level of the Medicare appeals process to compel the Agency to meet the deadlines for reviewing an appeal.  Read more...

DME Suppliers host key meetings with Energy and Commerce committee members Cathy McMorris-Rodgers (WA) and Larry Bucshon (IN)

Peaks & Plains Medical hosted a wonderful event with Congresswoman Cathy McMorris-Rodgers at their Spokane, Washington office. Yesterday, over a dozen providers across the state were able to attend which was a strong showing of support to direc

t towards the Congresswoman. With this support Rep. McMorris-Rodgers took great interest in signing on to the H.R. 3229 CRT bill, which will exclude CRT accessory items from competitive bidding. A big shout-out to those in attendance for showing just how important these issues are to the industry!

Vice President of Peaks & Plains, Leigh McNellis, reports back that the Congresswoman was very supportive about the issues that providers had brought to her. “Washington Providers were given a renewed sense of hope to have Congresswoman Cathy McMorris-Rodgers’ support on keeping access to medical equipment and supplies to rural Washington clients with an engaging discussion of the issues at hand,” said McNellis.

Patient Privacy Bill Approved in Oregon Senate
SALEM – The Oregon Senate approved HB 2758 this morning, legislation that will help protect the privacy of the health care consumers. The bill will ensure that Oregonians who are covered by another person’s insurance policy have the option to request that private health care communications be sent to the patient, not the policy-holder.  Read more...

Hatch, Wyden Praise Committee Passage of the Audit & Appeal Fairness, Integrity, andReforms in Medicare Act of 2015

WASHINGTON – Senate Finance Committee Chairman Orrin Hatch (R-Utah) and Ranking Member Ron Wyden (D-Ore.) today applauded committee passage of the Audit & Appeal Fairness, Integrity, and Reforms in Medicare (AFIRM) Act of 2015, an original bill to improve the Medicare audit and appeals process.  The legislation was reported out of the Committee by a voice vote.

“Today, the Committee took an important bipartisan step toward streamlining the Medicare audit and appeals process to help healthcare providers better serve millions of patients across the nation,” Hatch said. “This is a common sense bill that will help untangle the web of red tape that ensnares the current audit and appeals process and guarantee Medicare patients continue to have access to high-quality care. I look forward to continuing to work with my colleagues on both sides of the aisle to move this bill forward.”

“The Finance Committee has passed a strong, bipartisan bill that will begin to ease the tremendous backlog of Medicare appeals that have been frustrating seniors and providers in Oregon and across the country,” Wyden said. “Making the Medicare audits and appeals process more efficient will help resolve cases quickly and at the earliest possible step. I will be working hard to see swift action to help fix this broken system.”

An executive summary of the committee markup will be posted here.

Additional information on the AFIRM Act can be found here.

Annual CHPW Provider Workshop Invitation

Please accept my personal invitation to join us for our upcoming Annual Provider Workshop!  The invitation flyer is attached and includes dates, locations, and for your convenience, we are offering two sessions again this year (AM or PM).  For easy and quick registration click here for on-line registration and it will take you directly to the registration page.  Please don’t hesitate to contact me if you have any questions…

We look forward to seeing you there!

Carmen Switzer
Provider Relations Administrator
Community Health Plan of Washington
206-708-5380 (direct)
206-521-8833 (general)
206-613-5018 (fax)

HIPAA-HELP email address is working again.

The Washington  State Health Care Authority (HCA) has fixed the issue regarding the email address, and it is now working again.  Use the email address to submit HIPAA-related questions to HCA.

Continue to use the to submit client date of birth/gender mismatch questions to HCA.   

NOTE: Please do not reply directly to this Listserv message. If you have feedback or questions, please use one of the email addresses above or visit the HCA website at that way your message can be delivered to the appropriate staff.