Stakeholders push for payment freeze

Thursday, January 28, 2016

WASHINGTON – Industry stakeholders are shifting gears in their fight against Medicare’s competitive bidding program.

Stakeholders are now advocating for a freeze of the current reimbursement rates in regional and rural areas, according to AAHomecare’s weekly bulletin, “Wednesday in Washington.”

“While these initial phase-in cuts will certainly cause financial hardships for HME suppliers in rural/non-bid areas, we believe that working to prevent planned subsequent cuts that could reduce prices for many items by as much as 45% is the best approach to keep these suppliers afloat and help maintain critical access to products and services,” the association stated in the bulletin.

On Jan. 1, Medicare began paying for HME in regional and rural areas based on a 50/50 blend of the previous fee schedule amounts and the bidding amounts. On July 1, it will pay for HME in those areas based only on the bidding amounts.

Previously, stakeholders were focusing their attention on bills in the Senate and House of Representatives that included a longer phase-in period for the reduced reimbursement and a 30% increase to reimbursement in rural areas and a 20% increase in regional areas.

The industry’s champions in the House and Senate have “reacted positively to the proposal as a realistic course of action to get legislation passed this year,” AAHomecare said.

“In addition, we hope to engage CMS to consider freezing the rates at the current phase-in levels beyond the six-month period before further cuts take place,” it said.

Stakeholders agreed on pursuing the freeze after considering “a range of options and approaches,” AAHomecare said.

“We believe that this approach represents the best chance to keep the deepest and most damaging cuts from wreaking further havoc on rural/non-bid HME suppliers,” it said.