AAH’s Tom Ryan: ‘We’re not there yet’

Friday, July 8, 2016

WASHINGTON – The HME industry may be up against its toughest challenge yet in its bid to slow down the spread of competitive bidding.

Now that both the House of Representatives and the Senate have passed bills to delay a second round of Medicare reimbursement cuts that went into effect in non-bid areas on July 1, leadership in both chambers is trying to hammer out a final bill—and fast.

“The biggest constraint we have now is time,” said Cara Bachenheimer, senior vice president of government relations for Invacare.

Congress plans to recess on July 15 and not return until September.

As part of hammering out a final bill, leadership must decide on the length of the delay (the House bill calls for three months; the Senate bill calls for one year) and the pay-for. Only the Senate bill included an HME specific pay-for: speeding up plans to match the federal portion of Medicaid allowables to bid-adjusted Medicare allowables from Jan. 1, 2019, to Oct. 1, 2018.

“There are political issues beyond us that are involved with this,” Bachenheimer said. “There are powerful people in the House that continue to be staunchly opposed to a Medicaid pay-for. We need to get agreement on a pay-for, or get another one going.”

So in a final push, stakeholders are asking providers to pressure their lawmakers, particularly those on the Energy and Commerce Committee in the House, to come to an agreement before the upcoming recess.

“The message is, ‘It’s too quick,’” Bachenheimer said. “No one has even had time to assess the initial cut, which is significant. We’re not stopping the program altogether. We’re just taking a breath.”

The first round of cuts that went into effect Jan. 1 in non-bid areas represented cuts of, on average, 25%. The two rounds of cuts together represent cuts of, on average, 51.1%, according to an analysis by AAHomecare.

Among the scenarios that could play out by July 15, stakeholders say: Best case, leadership decides to go with the Senate bill; worst case, they can’t come to an agreement and the bills stall. Somewhere in between: Leadership decides to go with the House bill, ideally with the promise of extending the delay when Congress is back in session in September.

“The good news is that we’ve shown that in both chambers there is a want and need to get something accomplished,” said Tom Ryan, president and CEO of AAHomecare. “We’ve been working 18 months for this, and what we’ve accomplished is tremendous, but we’re not there yet.”

Because there are politics at play that the industry can’t control, it must control what it can: leveraging the grassroots lobbying that has gotten it this far.

“We need to raise the noise level,” Ryan said.


Capital Hill has no clue who needs funding cuts. Try looking at the hospitals with the piano bars and waterfalls who charge for services not rendered on a regular basis. Go in for a knee replacement and get charged for morphine that you didn't receive because you are allergic to it or how about the oxygen charged for each day when you never had a cannula in your nose? True story! Now they hit the poor HME's with a 50% cut in payment? Cut the pay on the Hill 50% and see what they say. What happens when the DME's go out of business because of these cuts and no one is there to service the needs of a relative of a congressman? A senator's mother is stuck on 6th and Elm in her power chair or runs out of oxygen but the HME she got it from is no longer in business. No amount of money can fix her problem because no one is still in business to give her service. If there is no pain on Capital Hill, they will continued to make these ridiculous cuts. Little do they know that they are cutting their own throats because by the time they wake up...it will be too late.