Bill to Reform Bid Expansion Hits House

Providers urged to lobby on behalf of H.R. 4185 and S.2312 now to get them attached to debt ceiling legislation before Dec. 11.

• By David Kopf
• Dec 08, 2015

Reps. Tom Price (R-Ga.) and Tammy Duckworth (D-Ill.) have introduced new legislation into the House that would reform CMS’s nationwide expansion of competitive bidding in ways that would better protect rural providers and patients from the expansion, the American Association for Homecare announced today.

H.R. 4185, titled The Protecting Access through Competitive-pricing Transition (PACT) Act, is a companion bill to S. 2312, the DME Access and Stabilization Act, which was introduced into the Senate by Sens. Senators John Thune (R-S.D.) and Heidi Heitkamp (D-N.D.).

Like the upper chamber’s bill, H.R. 4185 would:

• Apply a 30 percent increase to single payment amounts (SPA), calculated on a regional basis, for suppliers in non-bid areas.
• Phase in the bidding-derived pricing over a two-year period in non-bid areas, rather than CMS’s six-month phase-in.
• Set the ceiling for future bidding rounds of the competitive bidding program at the unadjusted fee schedule rates that went into effect on Jan. 1, 2015, instead of CMS’ proposal to set a bid ceiling at the previous bid amount rates. The AAHomecare noted this is an important component of the legislation that will benefit all providers subject to competitive bidding rates in future bidding rounds.
• Instruct CMS to revisit pricing adjustments for non-bid areas that takes into account travel distance, clearing price and other associated costs for furnishing this equipment for prices that will be in effect on Jan. 1, 2019.

Where the House bill diverts from the Senate companion is through a key addition: H.R. 4185 would implement a Market Pricing Program (MPP) demonstration project in order to compare an alternative methodology for achieving sustainable savings while preserving access to medically necessary equipment, supplies, and services to beneficiaries. 

As many HME Business readers might recall, Rep. Price re-introduced H.R. 1717 into the 113th Congress in 2013 — the so-called MPP Bill — which would have repealed and replaced competitive bidding with the industry-backed MPP. (Read more about H.R. 1717, Price's follow-up to legislation he originally debuted the 112th Congress in 2012.)

The PACT Act's 10-site MPP demo would include the same DME items as the Competitive Bidding program; require binding bids; weigh historic capacity of bidders; and determine price based on the clearing price. A separate auction will occur in two states for diabetes testing supplies.

Urgent Call to Arms for All Providers

AAHomecare, various state associations and legislative experts are calling on providers to join the lobbying effort on behalf of both pieces of rural bidding-relief legislation immediately. That lobbying effort to gain co-sponors will help support the industry associations’ efforts drive to work with the committees of jurisdiction in order to get the legislative language attached to Federal debt ceiling legislation before Dec. 11, which is the date by which Congress must act in order to avoid another government shutdown.

“We urge HME providers, manufacturers and other stakeholders in our industry to express their support for this legislation to their Representatives in the House as soon as possible,” AAHomecare exhorted in a public statement.

AAHomecare outlined an action plan to help providers accomplish their advocacy efforts:

• Send a letter to Congress in support of S. 2132 and similar forthcoming House legislation on rural relief under the competitive bidding program.
• Call their Senators and Representative (providers can find office contact information here) to advocate on behalf of the bills.
• Urge House Republicans to contact Speaker Ryan to support including H.R. 4185 in omnibus spending package.
• Tell House Democrats to contact Leader Pelosi to support including H.R. 4185 in omnibus spending package.
• Press Senate Republicans to contact Majority Leader McConnell to include S.2312 in omnibus spending package.
• Lobby Senate Democrats to contact Minority Leader Reid to include S.2312 in omnibus spending package.
• Ask for the name and email address of their lawmakers’ aide who handles healthcare legislation, and follow up with an email to those staffers.

Additional resources provided by the association:

• Full text of the bill.
• A Dear Colleague letter in support of legislation from Rep. Price.
• A section-by-section summary of the legislation.
• Providers can find individual Congressional office phone numbers here at action.aahomecare.org/congress/ or by calling the main Capitol switchboard at (202) 224-3121.
• Issue briefs, analyses, charts and data at www.aahomecare.org/issues/competitive-bidding.

“This new legislation recognizes the unique challenges and expense associated with serving patients in less-densely populated areas nationwide,” said AAHomeare President and CEO Tom Ryan. “Without this relief, many rural home medical equipment providers will be forced to consider closing their doors or reducing the range of products they offer.

“Seniors in rural areas, as well as individuals with significant disabilities and chronic conditions, are fortunate to have Congressman Price and Congresswoman Duckworth on their side,” Ryan added. “Their leadership in crafting and introducing this legislation will help individuals in these vulnerable populations to stay in their own homes, reduce hospital visits, and remain active in their communities.”