Stakeholders line up for July 1 fight

‘There’s a tremendous amount of activity at the highest level’
Friday, February 19, 2016

WASHINGTON – Industry stakeholders and their champions in Congress are mapping out a strategy to stave off a second round of reimbursement cuts scheduled for July 1 in non-bid areas.

Members of the Senate Finance Committee are in the process of drafting a letter to CMS, asking the agency to use its regulatory authority to delay the second round of cuts, says Tom Ryan, president and CEO of AAHomecare.

“Six months is not long enough to determine the impact of the first cuts on access,” he said. “If we can get a delay, it buys us more time until we have a new Congress and it’s not an election year, and there could be an easier path for legislation.”

CMS implemented the first round of cuts to reimbursement in rural and regional areas on Jan. 1. Stakeholders argue that, with providers in those areas still receiving cash flow from 2015, it may be months before they, and just as importantly their patients, are impacted by the cuts.

At the same time, AAHomecare is also putting the pieces in place for legislation to freeze current reimbursement; delay any additional cuts, ideally for three years; and require CMS to publish a new rule that takes into consideration the costs of providing services in rural and regional areas. It has hired Dobson DaVanzo and Associates to determine the cost of various scenarios and delays. It has also engaged Prime Policy Group to ramp up support in the House Energy and Commerce Committee, where it believes it has lacked support for previous legislation calling for a 30% increase to reimbursement in rural areas and a 20% increase in regional areas.

“We were so close (to getting that legislation passed),” Ryan said. “We did a root-cause analysis and we found that we needed a little more support on Energy and Commerce. (Prime) has the right skill set in place to help move our issues.”

This is just a glimpse of the work being done behind the scenes to address reimbursement cuts in non-bid areas, stakeholders say.

“Although there’s not a lot to report about introducing bills and gaining co-sponsors, there’s a tremendous amount of activity at the highest level,” said Jay Witter, senior director of government affairs for AAHomecare.

With July 1 approaching and Congress looking to adjourn early for their August recess due to the upcoming elections, stakeholders acknowledge they have a small window to work with. But they have a strong foundation to work from, they say.

“The details have yet to be resolved, but the good news is we have bipartisan champions in both chambers who are committed to figuring out a way to stave this off,” said Cara Bachenheimer, senior vice president of government relations for Invacare.