Bid bills likely to get reintroduced in January

Friday, December 19, 2014

WASHINGTON – After a disappointing week in which both the House and the Senate went home without passing any HME industry legislation, stakeholders have begun regrouping for 2015.

“I think the window simply closed on us,” said Tom Ryan, president of AAHomecare. “We have to be ready to come out of the box in 2015. It’s not over yet.”

The industry certainly got a lot further with its efforts to reform the bidding program in 2014, including its first Senate bill, S. 2975, which was introduced Dec. 4, by Sens. Rob Portman, R-Ohio, and Ben Cardin, D-Md.

“We were happy to get that bill—it added legitimacy to the effort and concerns of our lawmakers on the need for binding bids,” said Ryan. “Some of the old school who were against us are much more empathetic.”

The plan now is to get the Senate bill and its companion, H.R. 4920, which garnered 68 cosponsors, reintroduced as soon as possible after the 114th Congress convenes on Jan. 6.

With the opening of the bid window slated for Jan. 22, there’s no time to waste, said Jay Witter, who met with the Speaker’s office last week.

“They understand the time pressure we are under,” said Witter, senior vice president of public policy at AAHomecare. “If something doesn’t happen quickly, it will be difficult to make changes (after the fact).”

Adding to that sense of urgency: CMS has shortened the bid window to 63 days, instead of the usual 90 days. The window closes March 25—one week ahead of the March 31 deadline to pass a new sustainable growth rate (SGR) or “doc fix” bill.

“The SGR is an opportunity to include a number of other Medicare issues,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “That shortened bid window is eyebrow-raising.”

Stakeholders were also critical of the latest competitive bidding report from the Government Accountability Office (GAO), which examined the Round 1 recompete, Round 2 and the national mail-order program.

“They didn’t do any independent analysis and they didn’t ask some of the critical questions,” said Bachenheimer. “They just parroted CMS.”

Meanwhile, AAHomecare and other industry stakeholders have begun to identify priorities for the new year. Topping the agenda: prior authorizations and audit reform.

Although a bill to reform the audit process, H.R. 5083, also failed to pass, the $1.1 trillion “CRomnibus” spending bill, signed into law Dec. 16, contained language that was “very critical of the backlog,” said Witter. That backlog of appeals at the ALJ currently numbers more than 900,000 and growing.

“There are other efforts out there (with regard to audits) and we’re talking to the American Hospital Association and other groups that want relief,” he said. “With the Senate Finance committee looking to do some audit reform, there’s going to be some audit legislation.”