President Obama has signed the 21st Century CURES Act into law, including provisions that offer relief to providers and patients affected by the national expansion of competitive bidding to non-bid areas.
President Obama (left) and Vice President Biden (center) applaud passage of 21st Century CURES Act. Video of the bill signing ceremony is available at https://youtu.be/aOraimWg5bs.
Passed by the House and Senate, the CURES Act combined a wide variety of healthcare provisions such as funding $1.8 billion for research into curing cancer, and programs to map the human brain and fight drug addiction. Prior to signing the bill, President Obama had said that he looked forward to approving the legislation.
“We are bringing to reality the possibility of new breakthroughs to some of the greatest healthcare challenges of our time,” Obama said. “It is wonderful to see how well Democrats and Republicans in the closing day of this Congress came together around a common cause. And I think it indicates the power of this issue and how deeply it touches every family across America.”
Where HME is concerned, the CURES Act provides retroactive relief to non-bid providers by extending the initial phase of partial reimbursement cuts to impacted items from ending on June 30 to ending on Dec. 31, and pushing implementation of the full reimbursement cuts, which had started on July 1, cut to Jan. 1, 2017. CMS will reimburse post-July 1 claims for the difference between the partial reimbursement cut and the full reimbursement cut.
Other key, bidding-related provisions in the CURES Act:
- The legislation delays the application of competitive bidding-derived reimbursement cuts to accessories for Group 3 complex rehab mobility devices another 12 months until July 1, 2017. A previous 12-month extension had been secured in December 2015.
- The bill instructs the Department of Health & Human Services to study on the impact of the bidding program on the total population of HME providers and patient access to HME over the course of 2016.
- In order to provide more permanently relief to rural HME providers and patients, the legislation requires HHS to reissue payment regulations for items and services furnished on or after Jan. 1, 2019, with adjustments to the non-bid fee schedule in some areas based on stakeholder input, costs, volumes and the population of suppliers serving those areas.
- Given the congressional desire for budget-neutral legislation, one of the CURES Act’s pay-fors comes in the form of an acceleration of the plan to limit state Medicaid reimbursement rates for HME to the Medicare fee-for-service payment rates, including items those will competitive bidding-derived rates. Rather than apply those rates in January 2019, the application would be ramped up by one year to Jan. 1, 2018.
While the rural relief was welcome, AAHomecare noted that much work has to be done. The association used the example of Zurcare, a Ridgeland, Miss.-based provider that had been serving patients since 1990 until it decided to close the doors on its final two locations on Nov. 30 due to competitive bidding cuts to drive home its point that broader bidding reforms are needed.
“It is a harsh reality the HME community has been struggling with in 2016, and we are sure to see more businesses closing in 2017 if Congress cannot come together to deliver a longer-term fix for unsustainable Medicare reimbursement rates under the competitive bidding program,” a statement from the association read. “While the CURES bill is a step forward in the campaign for fair and sustainable Medicare reimbursement policy, AAHomecare and leading HME stakeholders are getting ready to hit the ground running when the 115th Congress and new HHS leadership get to work in 2017 — and we look forward to again building on the passionate support of HME providers across the nation so that companies like Zurcare, that faithfully served their communities, have a fighting chance to stay in business.”