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Stakeholders, largely in wait mode, keep close eye on DC 

Stakeholders, largely in wait mode, keep close eye on DC  ‘We suspect the final rule needs to be reviewed. The concern is it may take some time’ 

WASHINGTON – With a new administration, a new Congress and new leadership at CMS and HHS still taking shape, there won’t be a lot of action on HME priorities for the next few months, say AAHomecare officials. 

Among those priorities is a final rule expected to include a host of DME-related provisions. 

“The new administration is reviewing all regulations and still getting staff on board,” said Jay Witter, senior vice president of public policy for AAHomecare. “We suspect that the rule needs to be reviewed. The concern is it may take some time.” 

Among the DME-related provisions expected to be in the final rule are methodologies for adjusting the fee schedule payment amounts for DMEPOS items furnished in former bid areas.  

In comments that AAHomecare submitted to the proposed rule, the association made the case for a 90/10 blended reimbursement rate in former bid areas, to go along with the 50/50 rates in rural areas, which are permanent, and the 75/25 blended rates in non-rural, non-bid areas, which are good through the public health emergency. 

“The rule maintains the 50/50 rates for rural areas, and we want to preserve that,” said Tom Ryan, president and CEO of AAHomecare. “We still have to come up with an industry consensus on where the No. 1 priority would be.” 

One priority that is in play right now: getting Congress to extend the moratorium on 2% Medicare sequester cuts until the end of the PHE. The moratorium is set to expire April 21, but the new administration has indicated the PHE could continue through the end of 2021 and has promised to provide 60-day notice. 

“That 2% makes a significant difference” says Ryan. “It’s quite expensive (to provide services in the pandemic). And the 60-day notice is better than the last administration rolling the dice.” 

With new members of Congress still settling into Washington, D.C., and sorting out committee assignments, stakeholders say they are focused on relationship building.  

“Some of our champions are in key committee leadership roles,” says Witter. “We are just maintaining those and reaching out to new members of Congress now that things have settled down.” 


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