Industry in waiting 

WASHINGTON – CMS’s decision to delay finalizing a proposed rule could signal the agency’s intent to focus on other matters, say industry stakeholders. 

“We believe CMS is planning on issuing a proposed rule to modify the bid program,” says Cara Bachenheimer, who heads up the government affairs practice at Brown & Fortunato, where she is also a shareholder. “My guess is they are focused on that.”  

In a notice published in the Federal Register April 26, CMS said it is not be able to finalize a May 2018 interim final rule by May 2021 as required by law. The agency also said it was still reviewing comments made on an Interim Final Rule published in November 2020. 

That rule would have extended 50-50 blended rates in rural areas that were put in place under the CARES Act. 

“We are concluding they have no plans to finalize the November 2020 payment rule anytime soon,” said Bachenheimer. “That’s not good because it would make the higher 50-50 rates permanent.” 

Also likely at play in CMS’s decision to kick the can down the road: The agency still has no administrator. While nominee Chiquita Brooks-LaSure is widely expected to be confirmed, Sen. John Cornyn, R-Texas, has placed a hold on the nomination over a rescinded Medicaid waiver for Texas.  

“We are waiting to get the administrator confirmed and going on record with our asks,” said Tom Ryan, president and CEO of AAHomecare. “We are reiterating our support of the 50-50 blend and asking for an increase in the single payment amount rates (in other areas).”  

Behind the scenes, Jay Witter, senior vice president of public policy for AAHomecare, has been meeting regularly via Zoom with lawmakers and their staff to express concerns with everything from the need for permanent telehealth waivers to the impact of a possible 4% cut in 2022 as required by the recently passed $1.9 trillion stimulus package.   

“We are in this tough period,” he said. “We are working to set up official positions and get to a point where we can do grassroots and have legislation (ready to go).”