Stakeholders set out to control what they can

Passing H.R. 4229 is unlikely in next few weeks
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Friday, November 16, 2018

WASHINGTON – Now that the elections are over, industry stakeholders say it’s hard to predict what—if anything—will get done in the lame duck session.

“Nobody knows what’s going to happen,” said Cara Bachenheimer, chair of the government affairs practice at Brown & Fortunato.“ So let’s focus on what we can control and continue what we are doing, which is calling attention to why bid relief is needed.”

A recent final rule was a mixed bag for the industry’s efforts to reform Medicare’s competitive bidding program. It extends blended reimbursement rates to rural areas, for example, but not all non-bid areas.

The lack of additional relief in the final rule shifts the industry’s focus back to Congress and on to H.R. 4229. While Congress plans to pass an appropriations bill before Dec. 7 to avoid a government shutdown, it’s unlikely that that bill or any other will serve as a vehicle for H.R. 4229 before the end of the year.

“If H.R. 4229 doesn’t get passed, it’s still a viable package,” said Bachenheimer. “It will have to be modified, given the final rule, but it’s a great placeholder (for a new bill next year).”

The bill, introduced by Rep. Cathy McMorris Rodgers, R-Wash., who won re-lection, has 157 co-sponsors.

Adding to the overall uncertainty: The lame duck session is set against the chaos of a Congress in transition, as newly-elected lawmakers begin the process of moving in and going through orientation, and Democrats jockey for position in the House of Representatives.

“You have the new wave of folks who think they have a mandate to make changes; and you have the old guard, which hasn’t been very supportive of our issues, trying to hold onto power,” said Jay Witter, senior vice president of public policy for AAHomecare.

AAHomecare has begun outreach to introduce the HME industry and its myriad issues to new members. One familiar name: Dan Meuser, former president of Pride Mobility Products and brother to current chairman and CEO Scott Meuser, won his bid to represent Pennsylvania’s 9th congressional district.

“We added a great champion there,” said Witter.

As always, stakeholders also continue to work with CMS on competitive bidding, including commenting on the agency’s proposal to include braces and ventilators in the next round of the program; and teasing apart sub-regulatory issues related to the recent final rule, like vetting supplier capacity and beneficiary demand, says Bachenheimer.

“We have a dialogue going with CMS,” she said. “We’re putting all those ducks in a row.”