Stakeholders work to line up legislation

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Friday, March 1, 2019

WASHINGTON – AAHomecare is working to get a bill to provide additional relief from Medicare’s competitive bidding program introduced in the House of Representatives and the Senate in time for the Washington Legislative Conference in May.

“We’re working with House and Senate champions on legislation that would provide additional relief to rural, non-CB and non-rural/non-CB areas,” said Jay Witter, senior vice president of public policy for the association.

In a final rule published late last year, CMS agreed to extend 50/50 blended reimbursement rates in rural areas through Dec. 31, 2020, but not for all non-bid areas. It also neglected to apply CPI adjustments to rates in bid areas retroactively from 2008-12.

Witter declined to provide specifics on the bill but said, “We’ve had positive meetings with both the House and Senate folks. They understand the need for additional relief.”

AAHomecare is also working to get a bill introduced to address the application of a “budget neutrality offset” to home oxygen therapy. Stakeholders argue this creates a “double dip” in reimbursement.

“AAHomecare has talked with CMS numerous times about the O2 budget neutrality issue, but the agency has indicated it does not have the statutory authority to change it,” Witter said. “This means that federal legislation will be necessary.”

While it works to have hard asks for its legislative conference May 22-23, AAHomecare has also been funneling recommendations to CMS on the next round of bidding, including product categories on Jan. 17 and on bidder capacity evaluations on Feb. 7.

“In addition to increased transparency, the overarching message was, you should only establish capacity based on a bidder’s historical capacity, not projected capacity,” said Cara Bachenheimer, head of the government affairs practice at Brown & Fortunato.

Stakeholders are now working on recommendations on bona fide bids, which will likely include a recommendation that CMS include non-lead items, not just lead items, in its verification process.

Of course, stakeholders, along with those in Congress, are also waiting for CMS to release additional information on the next round of bidding. The first information likely to come out: product categories and a timeline.

“Everyone is on pins and needles,” said John Gallagher, vice president of government relations for VGM. “With the wall and government shutdown mostly behind us, we’re hoping regular order picks up a little bit. We have meetings scheduled.”