Competitive bidding: Stakeholders line up another campaign for relief

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Friday, May 17, 2019

WASHINGTON – The industry has its marching orders this week, as it heads to Capitol Hill with a long-awaited bill to address Medicare reimbursement cuts for HME.

Specifically, H.R. 2771 would make permanent a 50/50 blended reimbursement rate in rural areas and would introduce a 75/25 rate for non-rural, non-bid areas.

“We worked for the last three years with Congress and the administration to implement relief in non-bid, non-rural areas,” said Jay Witter, senior vice president of public policy for AAHomecare. “This is something that was proposed in the interim final rule and is seen as very reasonable. It’s not as much as the rural folks are getting, but it’s a lot better than what they are receiving now.

The Protecting Home Oxygen & Medical Equipment (HOME) Access Act of 2019, introduced May 15 by Reps. Cathy McMorris Rodgers, R-Wash., and Dave Loebsack, D. Iowa, updates past legislation with language from an interim final rule that sought feedback on additional relief for non-rural, non-bid areas and a final rule, both published in 2018.

A third component of the legislation would eliminate the oxygen budget neutrality requirement—something stakeholders have long argued amounts to a “double dip” cut that positions rates for oxygen concentrators in rural areas below bid rates.

“That amounted to a 10% to 15% cut outside the CBAs,” said John Gallagher, vice president of government relations for the VGM Group. “That was never the intent of Congress.”

McMorris Rodgers’ previous version of the bill, H.R. 4229, introduced during the last Congress, ultimately garnered 158 co-sponsors from both sides of the aisle, something it will need to do again this go-round.

“We are trying to focus on getting a lot of signatures,” said Cara Bachenheimer, head of the government affairs practice at Brown & Fortunato. “It’s a difficult time in D.C. with anything, given the political situation, and anything that goes through will have to be bipartisan.”

Hundreds of providers headed to AAHomecare’s Washington Legislative Conference this week are ready to jump into action, says Tom Ryan.

“It’s going to take time; it’s going to be a long haul,” said Ryan, president and CEO of the association. “CMS has admitted the program is broken, there’s an admission of access issues and, if they want a sustainable bid program, they need to give us some relief.”