Industry on president's budget: 'It sounds a little more like a plan'

WASHINGTON - Although a proposal to expand Medicare's competitive bidding program to rural areas also appeared in the president's budget last year, new details have raised eyebrows, say industry stakeholders.

The budget, published Feb. 10, proposes expanding competitive bidding to other geographic areas, including rural areas, beginning in 2024. It also proposes that the single payment amounts be based on individual winning bid amounts, rather than the maximum winning bid amounts employed for Round 2021.

“It sounds a little more like a plan, and that's concerning,” said Jay Witter, senior vice president of government affairs for AAHomecare. “We've reached out to folks on Capitol Hill, and we're trying to get a meeting with CMS to see if this is just a proposal or is what they plan to do moving forward.”

AAHomecare has already spoken with Alex Azar, the secretary of the Department of Health and Human Services, to let him know the proposal is not something the industry supports and that it could impose more burdensome requirements on providers, Witter said.

The budget also includes a new proposal to use retail pricing to adjust the fee schedule rates for non-bid items. While it wouldn't apply to many items, it essentially replaces inherent reasonableness, says Cara Bachenheimer, chair of he government affairs practice at Brown & Fortunato.

“CMS is looking at online pricing, which is ridiculous in terms of the differences in buying for cash from Amazon versus having something delivered and all the services that go with it,” she said.

While many deem the president's budget “dead on arrival,” the proposals in it can provide ideas to lawmakers looking to fund other initiatives.

“If it's dead, let it die, but we've got to make sure we are cognizant,” said John Gallagher, vice president of government affairs for VGM. “Once the budget is put forward and scored, parts of it can be pulled out and utilized. If they are looking for dollars, that's what's out there.”