Stakeholders fine-tune message in August

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Friday, August 3, 2018

WASHINGTON – As lawmakers head into their August recess, industry stakeholders will keep the focus on a recent proposed rule overhauling Medicare’s competitive bidding program.

CMS is accepting comments on the proposed rule, which would, among other things, not extend the current bid contracts and temporarily allow any Medicare-enrolled provider to serve beneficiaries, until Sept. 10.

“CMS has made some dramatic improvements, but we’re lining up some additional refinements and tinkering with the details,” said Cara Bachenheimer, chair of the government affairs practice at Brown & Fortunato. “I think keeping legislators involved and sharing how the industry feels about where CMS is at is important to communicate over the next few weeks.”

Industry response to the rule, which would also swap median price for clearing price, has been largely positive.

However, the proposed “any willing provider” provision could actually create more, not fewer, access issues, says Karyn Estrella, executive director of the Home Medical Equipment and Services Association of New England, who will be talking up the issue with lawmakers in the region in August.

“Contracted suppliers are no longer bound by these large CBAs,” she said. “I know one large oxygen supplier who said they are going to significantly reduce their service area.”

Also a topic in August meetings: H.R. 4229, a bill that would extend 50/50 reimbursement rates and address the oxygen “double dip.” VGM’s John Gallagher and several HME providers will meet with the bill’s sponsor, Rep. Cathy McMorris Rodgers, R-Wash., on Aug. 6.

“We need to see what needs to be adjusted in the language going forward,” said Gallagher, vice president of government relations for VGM. “Our hope is that CMS makes the adjustments in the final rule, but we still have to have the language to use as a club to say, ‘Change it.’”

Although comments on the rule aren’t due until next month, AAHomecare is aiming for submitting theirs in mid-August, says Bachenheimer. With the final rule due Nov. 1, and reviews by the Office of Management and Budget and Health and Human Services, CMS is working with a very compressed timeframe.

“It’s important to get comments in as early as possible to ensure some consideration,” she said.