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Pressure builds to advance reimbursement relief

Pressure builds to advance reimbursement relief ‘This is what we’ve been preparing for’

ATLANTA – A small group of HME stakeholders is scheduled to meet with Rep. Brett Guthrie, R-Ky., on Wednesday for a “last good push” to get H.R. 6441 attached to a larger bill prior to the end of the year, Jay Witter said during the AAHomecare Update at Medtrade on Tuesday. 

Jay Witter, senior vice president of public policy for AAHomecare, along with John Gallagher of VGM Government Relations and Seth Johnson of Pride Mobility Products, are meeting with Guthrie, who is the Republican leader on the House Energy and Commerce Health Subcommittee, to advocate for extending a 90/10 blended reimbursement that’s currently in place for competitive bidding items in competitive bidding areas. 

“It took us a long time to get where we’re at, but this is what we’ve been preparing for,” Witter said. 

There will likely be two larger bills that will be voted on prior to the end of the year that H.R. 6441 could be attached to, Witter said: a bill for government spending and a bill for Medicare-related items. 

Stakeholders are also working with Sen. John Thune on a bill that would extend the 75/25 blended reimbursement rate that’s currently in place in rural areas for a set time beyond the public health emergency, Witter said.  

“The cost issues and the challenges with labor and fuel and the supply chain won’t end with the PHE,” he said. 

Additionally, stakeholders are seeking to address a potential 4% Medicare reimbursement cut related to deficit spending in Congress, Witter said. A 1% cut already went into effect from April to June, and then a 2% cut starting in July. 

“If Congress doesn’t fix that by the end of the year, that will be added to the 2% sequester cuts,” he said. “We’ve been talking about this for the past six or seven months, and now the rest of the health care sector is on board.” 

Other notables from the AAHomecare update: 

  • Tom Ryan, president and CEO of the association, on third-party administrators: “Are they a friend or a foe? They’ve had some major traction on the payer side – they have the opportunity to work with a lot of payers, but we also want them to work with the industry. We want them to know our pain points and feel our pain points, and advocate with us to payers.” 
  • Kim Brummett, vice president of regulatory affairs, on the next round of competitive bidding: “We’ve had some serious conversations with some senior folks at CMS and we don’t get the sense it’s a priority. They’re too busy unraveling the waivers. If I were a betting person, I’d say even 2024 is unlikely.” 
  • Brummett on the next CPI-U update for DME: “We maybe feel comfortable that it will be in the neighborhood of 8.7%, but it won’t be released until December. It’ll be a higher rate than we’ve had, but unfortunately, that’s because of inflation.”


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