AAHomecare closes in on key issues

Friday, May 9, 2014

WASHINGTON – Expect a trio of HME-related bills to drop in the next few weeks as, slowly but surely, industry stakeholders make headway in their efforts to improve the competitive bidding program and the audit system.

“We’re here to close a lot of issues,” AAHomecare President and CEO Tom Ryan told attendees at the annual Washington Legislative Conference last week. “We can’t do it without your help.”

The big news going into the conference: Rep. Renee Ellmers, R-N.C., plans to introduce the Audit Improvement and Reform Act. Although the language is still being fine-tuned, the bill would seek to, among other things, increase education and outreach about improper payment, reduce error rates, and require timely filing limits on claims subject to audits.

Ryan described the bill as “passable.”

“We’ve worked very hard on getting the points we needed in there, and the points the committees are comfortable with,” said Ryan. “It’s got the substance to be more than a message bill.”

Other bills in the works: Sen. Lamar Alexander, R-Tenn., has drafted language that would expand prior authorizations to include certain high-cost home medical equipment; and Reps. John Larson, D-Conn., and Pat Tiberi, R-Ohio, are working on a bill that seeks to require binding bids in future rounds of competitive bidding.

Also putting a bounce in attendee footsteps was a Senate sign-on letter being circulated by Sens. John Hune, R-S.D., Robert Casey, D-Pa., and John Hoeven, R-N.D. The letter comes in the wake of CMS publishing an advanced notice of proposed rulemaking seeking input on expanding bid prices nationwide in 2016.

It’s the first time Senators have spoken out on bid expansion.

“The Senate needs to send a message not to move forward with these prices,” Rep. James Renacci, R-Ohio, told attendees. “Every senator has rural areas that are going to be impacted.”

Renacci, a former HME provider, has firsthand knowledge of the impact of competitive bidding. He encouraged providers to send lawmakers his way if they needed to learn more about the flawed program.

“I’ve lived through it,” he said.

Although attendance at this year’s event was down sharply—150 attendees vs. about 260 the previous year—enthusiasm was high and many compared positive notes from the more than 250 meetings conducted on Capitol Hill.

“It’s been a long fight and the troops are weary,” said Karyn Estrella, executive director of the Home Medical Equipment and Services Association of New England. “But, I really feel like things are changing and starting to come together. I feel really positive.”

In addition to the anticipated bills, stakeholders are looking ahead to a pair of reports, possibly coming in June, from both the Senate Finance Committee and the Government Accountability Office (GAO) on audit issues.

“We’ll be taking a hard look at auditors, how many audits there are, appeal rates, CMS oversight, duplication,” said Kim Brandt, chief investigative counsel for the Senate Finance Committee told attendees. “Then we’ll work with the chairman to have a hearing after July 4.”