Still stuck on a score

Friday, March 23, 2012

WASHINGTON - There's still time to get the market-pricing program (MPP) passed, but industry stakeholders say it needs to be sooner, rather than later.

"We've been assured that there is time and opportunity to pass MPP," said Jay Witter, senior director of government affairs for AAHomecare. "We are looking to pass it as early as possible."

Right now, everything still hangs on getting the Congressional Budget Office (CBO) to assign a price tag to MPP.

That could happen as early as April, stakeholders say, thanks to pressure from members of both the House of Representatives and the Senate who want to see a score before deciding how to move forward.

"We have heard that MPP has moved up the priority list at the CBO," said Seth Johnson, vice president of government affairs for Pride Mobility. 

Once MPP is scored, it's up to lawmakers to decide what direction to take. Is introducing the bill the best strategy? Would it be a standalone bill or does it need to be attached to a larger piece of legislation? Do lawmakers want to have a hearing in the House on all the issues with the program?

"A lot of that is difficult to predict right now," said Cara Bachenheimer, senior vice president of government relations for Invacare. "It depends on the timing, and on what else is happening."

Ideally, the industry would like to see MPP passed before Congress recesses in August. Prof. Peter Cramton, the mastermind behind MPP, has said that's the latest date that would still allow time for MPP to be implemented before Round 1 kicks off July 1, 2013.

While that's still a possibility, it's more likely that the greatest opportunities will come during the lame duck session at the end of the year, stakeholders say. Among them: the doc fix and the payroll tax extension, as well as other appropriations bills that must pass by year's end, said John Gallagher, vice president of government affairs for The VGM Group.

"There are vehicles, but it's really going to take leadership involvement from both the House and Senate, and whether we get the support with Speaker Boehner and Senator Reid," he said. "Everything's based on that score."

Providers can take heart that lawmakers are increasingly aware that there are problems with the program, despite CMS's stance. At a pair of well-attended Hill briefings March 14, CMS is said to have indicated that the program is going well, but otherwise didn't offer a lot of details.

"We're hearing they were dissatisfied with CMS's responses," said Bachenheimer. "People had no assurance that it's under control."