Reimbursement ‘freight train’ approaching 

WASHINGTON – Industry legislation will be considered by the full Energy & Commerce Committee in the House of Representatives on Wednesday and stakeholders are hopeful lawmakers will see past partisan politics and focus on the very real issues at hand. 

H.R. 5555, which currently has 11 Republican and three Democratic co-sponsors, passed out of the E&C Health Subcommittee on Nov. 15 and now it’s up to the full committee to keep the bill in play.  

“We’re making sure the Democrats on the committee support it – they are concerned with the current situation with supplier reductions and access issues,” said Jay Witter, senior vice president of government relations for AAHomecare. “The real goal is the (larger package) – we have been talking with everyone about that.” 

Introduced Sept. 19 by Reps. Mariannette Miller-Meeks, R-Iowa, and Paul Tonko, D-N.Y., H.R. 5555 would provide a 90/10 blended Medicare reimbursement rate for most home medical equipment products in competitive bidding areas for all of 2024 and extend the current 75/25 blended rate currently in effect in rural/non-CBA areas through 2024.  

With those 75/25 blended rates set to expire on Dec. 31, there’s a renewed sense of urgency in the industry’s advocacy efforts, says Tom Ryan, president and CEO of AAHomecare. 

“There’s a freight train coming our way, and providers are going to feel the pain,” he said. “Even if they are able to hold their claims back, waiting for legislation to pass, cash flow management may be difficult. We need to put the light on the sense of urgency.” 

Advocacy efforts, including a Virtual Hill Day and an ongoing “Champions of Change: 55 in 55” campaign, are making a difference, say stakeholders. Case in point: Language from S. 1294 has already been included in a larger package that lawmakers are considering and that must pass in the beginning of the new year. 

“On the Senate Finance Committee, there’s a number of legislators that stepped up and said that they are hearing from constituents,” said Mike “Ike” Isaacson, senior vice president of government relations at VGM & Associates. “While I’d like them to get this done, we have the opportunity to continue making those calls and double down and keep checking back with those folks.”