Rekindling HME's Hope
Despite July's setbacks, the fight's far from over.
- By David Kopf
- Aug 01, 2016
“No one ever said it would
be easy, but they never said it would be so hard.” My
mental stereo has had those lyrics stuck on repeat
for the past several days. As I write this, the industry
is still reeling from the absolute shock of rural relief
stalling out in the Senate.
As you've read in recent news stories on this site, and perhaps in "The Rural Relief Rethink," the hard work
and dedicated advocacy done by the staff and members
of the American Association for Homecare, the state
associations’ staff and members, the VGM Group,
various manufacturer government relations experts,
and rank and file providers from across the country was
completely sidetracked by not one, but two completely
frustrating and completely unexpected events.
The whole story is illustrative of both the constant
roadblocks the industry must contend with, and the
dedicated, undaunted attitude of HME’s advocates.
Who could have predicted that the House’s initial
rural relief vote would get shut down by Democratic
lawmakers’ sit-in in the wake of the Orlando, Fla.
terrorist shooting? But, despite the fact that such a
development meant that rural HME providers and
their patients would have to suffer full reimbursement
cuts on July 1, the industry kept pushing to get
legislation passed after the fact.
And who could have predicted that, after the House
passed that follow-up legislation and the Senate then
hotlined a companion bill — usually a fast track to
approval — that those efforts would be undermined
by a single Senator’s last-minute hold late on the afternoon
before the Senate was to recess for the summer?
What are the chances of those two things happening
in such quick succession for the same legislative effort?
Mind you, that’s not a rhetorical question. I really
want to know the answer, because if the odds are long
enough, I suggest we all get together and start a lottery
pool. The next Powerball jackpot is calling our name.
Heck, we’re due; that’s for sure.
All jokes aside, I’m not going to lie — what
happened to rural relief was frustrating beyond
compare. I’m talking the gnashing your teeth and
pulling your hair kind of frustration. The kind of frustration
that makes you want to give up all hope.
But don’t do it. You need to get past the frustration
and stoke whatever small, smoldering embers of hope
you have remaining. We all need to, because, simply
put, the fight is not over.
I know that sounds crazy, with the July 1 rate cuts
now in full effect, but things don’t have to stay that
way. As you’ll read in this issue’s coverage, the industry’s
leadership and advocates are already working
with legislative champions in the House and Senate to
shape a new legislative strategy that they can advance
between when both chambers reconvene in early
September and the next elections.
And while they’re doing that, they desperately need
providers and patients to contact their Representatives
and Senators to share their frustration and reassert
how vitally important it is to protect rural access to
HME. Maintaining that “noise level” ensures that
lawmakers will understand the issue is not.
And for an industry that has seen so much vexation,
asking for help on yet another legislative effort
sounds like a tall order. If it feels like you just can’t
summon up any hope to get you motivated to support
that effort, here are three thing that should help you
muster a more positive outlook on the situation:
1. The industry succeeded in getting binding bids
legislation passed last year in order to eradicate the
scourge of suicide bidding. That’s a crucial victory.
In addition to requiring bidders to maintain state
licensure, the legislation requires bidders to obtain a
“bidding bond” that functions like a surety bond. This
way, if a bidder declines the contract and its bid was at
or below the bid price, then that bidder would forfeit
2. CMS just proposed a rule would shift the bid
ceiling to the 2015 fee schedule. That’s huge. The rule
would ensure that bids always have a fixed ceiling,
rather than dwindle reimbursement down to nothing
by using each successive re-compete as the ceiling for
the next re-compete. CMS essentially agreed with the
industry, by stating in the proposed rule’s language
that setting the ceiling to pre-bid levels ensured the
program’s long-term viability — the exact argument
the industry has made for some time.
3. The industry is in a very good position to resume
the rural relief fight after lawmakers return to Capitol
Hill in September. We can’t forget that despite the
two surprise setbacks that stalled out rural relief, the
industry succeeded in getting rural reform passed —
twice. And in under a month, no less. The political
will among lawmakers to protect rural HME access is
undeniable, and that will give the industry a serious
head start come September.
I don’t know about you, but those three facts put
July’s setback in an entirely different light. Yes, it’s
frustrating, but the fight’s clearly not over, and the
majority of lawmakers in both chambers are not only
on our side, but share our perspective. We all have
good reason to take hope and keep fighting.
This article originally appeared in the August 2016 issue of HME Business.
David Kopf is the Publisher and Executive Editor of HME Business and DME Pharmacy magazines. Follow him on Twitter at @postacutenews.