Industry buys time for rural providers, complex rehab accessories

‘It’s just the first step, but an important one,’ AAH’s Ryan says
Monday, November 28, 2016

WASHINGTON – The HME industry now has a vehicle in Congress for rolling back a second round of Medicare reimbursement cuts that went into effect in non-competitive bidding areas on July 1, AAHomecare reports.

A draft of the 21st Century CURES bill that will be considered by lawmakers this week has language that would roll back the cuts for six months. It paves the way for providers in non-bid areas to recoup reductions for items with dates of service from July 1 to the end of 2016, says Tom Ryan, president and CEO of the association.

“This legislation will help HME providers in rural areas stay in business and serve their communities, while we continue to work for a more realistic and sustainable pricing environment for all HME providers,” he said. “It’s just the first step in efforts to protect the rural HME infrastructure, but it’s an important one.”

Per the bill, the second round of cuts would again go into effect Jan. 1, 2017.

The bill also has language that would further delay Medicare’s plan to use bidding-derived pricing for accessories for complex power wheelchairs for another six months, until July 1, 2017. It extends an original 12-month delay granted by Congress in December 2015.

“This legislation will also ensure that individuals with significant disabilities continue to receive the specialized technology they depend on while we continue to advocate for a permanent fix that will keep CRT accessories outside the purview of the bidding program,” Ryan said.

Other proposals in the bill include:

·      Speeding up plans to limit state Medicaid reimbursement amounts for HME to the Medicare fee-for-service rates, including applicable bid rates, from January 2019 to January 2018.

·      Instructing the Department of Health and Human Services to conduct a study on the impact of the bid program on the overall number of HME providers and the availability of products over the course of 2016.

·      Requiring HHS to reissue payment regulations for items and services furnished on or after Jan. 1, 2019, with adjustments to the non-bid fee schedule in some areas based on stakeholder input, costs, volumes and the number of suppliers serving those areas.

AAHomecare expects the House of Representatives to take up the bill this week, followed by the Senate next week.


So what is this actually going to do? Roll back the cuts for 6 months? Wow we get recouped that money but the cuts start on January 1 2017. What a joke they think this is going to keep us rural providers in business? Well I can tell you might as well just start having us that haven't closed our doors start now because this is a slap in the face to all RURAL DME companies. I thought they were really going to bat for us and get something done this time. I guess not. We cannot keep buying dme equipment and getting reimbursed less than what we paid for the product. All political nonsense. They have let CMS get away with murder basically and I think we all are Tired of this.

Although I am thankful for what could be, I am also saddened to know that the cuts will resume January 1st.  The early Medicaid reduction will be a killer for us as well.   I'm not sure how the "pay fors" work, but it seems to me they could find it somewhere else than our industry.  We have no more to give and we are slowly bleeding out.