Q&A: Legislation is tough but necessary

Tuesday, June 21, 2016

Peter Thomas, who coordinates policy for the ITEM Coalition, a group that builds support for policies that will enhance access to assistive devices and technologies, will speak at the upcoming RESNA/NCART 2016 Conference, July 12-15 in Arlington, Va. He spoke with HME News about the power that Medicare wields over policy for federal health insurance and beyond.

HME News: What are the top policy priorities when it comes to assistive technology?

Peter Thomas: The top priorities of the ITEM Coalition include a delay in the second round of competitive bid pricing to DME in non-MSA areas of the country to preserve access, choice and quality of benefits to the greatest extent possible, and legislating a permanent separation of CRT from the generic DME benefit to better serve the needs of beneficiaries. 

HME: How can better policy increase access?

Thomas: Medicare policy often influences the policies of other federal payers and private health plans, so using Medicare as an opportunity to change policy has significant downstream effects.

HME: Why is legislation sometimes needed to change policy? 

Thomas: You can change policy through one of three processes: legislation, regulation, or through the courts. It is usually much easier to accomplish something informally by advocating to the federal agencies to take action without formal regulations. Legislation is tough to pass but sometimes it is necessary to pursue. 

HME: What policy are you most proud of helping with?

Thomas: Defeating, at least for now, the issuance of a very restrictive draft coverage policy for lower limb prostheses issued by the DME MACs last summer. 

HME: What’s the one thing that you’d like to see attendees take away from your session?

Thomas: Coordinated efforts to advocate for access to care are the most effective way to ensure that beneficiaries, and the providers who serve them, have their needs met. hme