A sustained growth rate (SGR) reform bill, the so called “doc fix” that would update physician reimbursement from Medicare, has become a double-edged sword for the industry when it comes to reining in competitive bidding.
As providers might recall, the industry made significant headway in the Senate by working with members of the Senate Finance Committee in December to develop various short- and long-term fixes to competitive bidding based on the Market Pricing Program that could be attached to the sustainable growth rate (SGR) reform bill.
While the activity ultimately resulted in just an amendment to require out of state providers to prove they are licensed at the time of bid submission, the effort did help the industry gain traction in the Senate. Moreover, the American Medical Association endorsed the agreement agreed to by the House Ways & Means Committee and the Senate Finance Committee.
However, the American Association for Homecare reports that the $150 billion required to pay for the doc fix has prompted some lawmakers to propose applying competitive bidding rates for Medicare to state Medicaid programs in order to cover the cost.
This is not the first time applying competitive bidding rates to Medicaid has been proposed in terms of covering SGR costs. And other similar proposals have been made as well, such as applying competitive bidding cost offsets to all DME categories.
AAHomecare said in a public statement that it “strongly opposes these reimbursement cuts and has fought against this irresponsible proposal for several years.”
For more details, read the issue brief that AAHomecare is sending to key members of Congress urging them to oppose the proposal.
The association has made an issue brief, “Congress Should Not Force States to Accept Flawed Medicare Rates – Issue Brief,” available for its members to download at https://www.aahomecare.org/issues/competitive-bidding.