Bid delay efforts run out of gas

Discussions will resume after July 4th recess
Friday, June 24, 2016

WASHINGTON – With efforts to delay a second round of Medicare cuts stalled, the HME industry finds itself between a rock and a hard place, stakeholders say.

“We’re regrouping and figuring out with our champions where we go from here,” said John Gallagher, vice president of government relations for The VGM Group, of the cuts set for July 1 in non-bid areas.

A modified version of H.R. 5210 was scheduled to go to vote last week, but an unexpected sit-in by House Democrats over gun control prevented anything from getting done before Congress adjourned for the July 4th recess.

Earlier in the week, the Senate unanimously passed its bill, S. 2736, introduced by Sen. John Thune, R-S.D.

“We’ve got all 100 senators—that’s huge,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “Sen. Thune needs to be commended for his leadership. That’s a lot of momentum.”

The modified House bill, which was met with some behind-the-scenes resistance over the proposed Medicaid pay-for, would delay the second round of cuts for three months, compared to 12 months in the Senate bill.

“It’s three months, but with the promise to extend it beyond that,” said Bachenheimer.

Having different versions of bills complicates things, stakeholders say.

“Once the House comes back, can they move quickly on the Senate bill with the different pay-for?” said Gallagher. “There’s lots of options in flux, and there will be lots of discussions when they get back.”

One talking point stakeholders will be bringing up: the new pricing set to go into effect July 1, which CMS released June 23, after Congress adjourned. The cuts factor in Round 2 re-compete pricing and range from 10% for insulin pumps to 80% for TENS units.

“We need to showcase that,” said Gallagher. “The rates are drastically lower than even we expected, and CMS knows that Congress is looking to make a change.”