Reps. Tom Price (R-Ga.) and Dave Loebsack (D-Iowa) are expected to launch a bill in the House next week that would reform the national expansion of competitive bidding to give relief to rural providers in particular, as well as fix competitive bidding’s bid ceiling.
A companion to S. 2736, the Patient Access to Durable Medical Equipment Act, the House bill would have identical language to its counterpart in the upper chamber, except for the pay-for provision. According to the American Association for Homecare, because some concern was expressed in the House, the industry champions launching the bill have included a placeholder pay-for, which will give House and Senate committees time to find an alternative.
If identical to S.2736, the bill will include provisions that would:
- Delay implementation of the second phases of reimbursement cuts for HME items in non-bid areas from July 1, 2016 until at least Oct. 1, 2017.
- Replace the bid ceiling for future rounds of bidding with the unadjusted fee service rates from Jan. 1, 2015, rather than CMS’ current plans to cap future bid ceilings at the previous bid rates.
- Require CMS to solicit stakeholder input and consider travel costs, volume, and clearing price, as well as the numbers of providers serving bid areas, when setting rates for Jan. 2019 and beyond.
- Require CMS to monitor and provide monthly online updates regarding Medicare beneficiaries’ access to HME and their health outcomes related to HME.
- Advance the start date of the federal portion of Medicaid reimbursement mirroring Medicare rates by three months, from calendar year 2019 to fiscal year 2019. This would push the start date from Jan. 1, 2019 to Oct 1, 2018.
Call for Support
AAHomecare called on providers to help back industry-wide efforts to lobby on behalf of the reforms.
“While we’ve heard encouraging reports from Capitol Hill offices that your calls and emails are being heard, our champions have asked for as much grassroots support as the HME community can muster,” a statement from the association read.
The association urged providers that hadn’t yet reached out to their House representatives to take the time to make the following request:
“Please co-sponsor competitive bidding rural relief legislation expected from Reps. Tom Price (R-Ga.) and Dave Loebsack (D-Iowa) next week; the legislation will be similar to S. 2736 which has already been introduced in the Senate – and let them know, in your own words, why you believe the next round (July 1) of bidding-derived cuts for rural and non-bid areas need to be delayed until the effects of the January 1 cuts can be fully assessed.”
To help providers with their advocacy work, AAHomecare has provided various online resources:
- A Congressional directory to help providers find their Representative. The association noted that if providers have a Representative who sits on the House Energy & Commerce Committee, their outreach is especially needed.
- An Issue brief on rural relief legislation.
- State-by-state maps showing CBAs as well as regional/non-bid and rural areas.