Bid bill has sticking point in the House

Friday, April 15, 2016

WASHINGTON – One month after the introduction of a Senate bill to delay competitive bidding cuts, industry stakeholders are still working to get a Democratic co-sponsor for a House companion bill.

The sticking point: The bill’s “pay-for,” which would speed up plans to limit federal Medicaid reimbursement for DME to the Medicare payment rates from Jan. 1, 2019, to Oct. 1, 2018.

“There’s a concern that, from a policy standpoint, we don’t want a pay-for that affects the senior or disability population,” Tom Ryan, president and CEO of AAHomecare. “We are trying to get some of that population to respond that the reality is that to move up the Medicaid pay-for three months on just those competitive bid items, that is not going to be as devastating as another 25% cut across rural America and the non-bid areas.”

The first round of cuts in non-bid areas went into effect Jan. 1. The second round of cuts are scheduled for July 1. The Senate bill, S. 2736, would delay the second round of cuts until Oct. 1, 2017.

Stakeholders say the good news is that lawmakers in the House are receptive to the meat of the bill. They believe the companion bill will drop in the next few weeks.

“There are always hurdles and this is just another hurdle we have to work through,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “The cuts, just on the face of it, are so dramatic.”

The Senate bill, introduced March 17 by Sens. John Thune, R-S.D., and Heidi Heitkamp, D-N.C., currently has 19 co-sponsors, including Sen. Rob Portman, R-Ohio, who signed on April 13. To boost support, AAHomecare last week hired an additional lobbyist, Jenn Higgins, a partner with Chamber Hill Strategies.

“She knows our issues extremely well and she’s passionate about our issues,” Ryan said.

Adding fuel to the fire that bid program is unsustainable: the recently released single payment amounts for the Round 2 re-compete, which saw an average reduction of 7.1%, over and above the original Round 2, according to an analysis by AAHomecare. CMS is in the process of offering 12,181 contracts to 637 bidders, but word on the street is that many providers are turning down the business.

“We are seeing a lot of folks backing away,” said John Gallagher, vice president of government relations for The VGM Group. “They are saying they can’t do it.”