House Gets Rural Relief Bill

With the Washington Legislative Conference around the corner, House lawmakers introduce legislation that would reform bid expansion to protect rural access.

Reps. Tom Price (R-Ga.), Dave Loebsack (D-Iowa), and Peter Welch (D-Vt.) have launched House legislation that would reform bid expansion to protect Medicare beneficiaries and their HME providers, particularly those in rural areas.

Called the Patient Access to Durable Medical Equipment Act of 2016 (H.R. 5210), the new legislation is a companion to S. 2736, the Patient Access to Durable Medical Equipment Act of 2016. The PADME Act has similar legislative language to its counterpart in the upper chamber, and includes 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.

However the PADME Act contains one key difference: While S.2736 advances the start date of the federal portion of Medicaid reimbursement mirroring Medicare rates by three months, pushing the start date from Jan. 1, 2019 to Oct 1, 2018, the House bill has included a placeholder pay-for, which will provide House and Senate committees with the time to find an alternative.

The full text of the legislation can be found here

“Every single day, many rely on durable medical equipment such as wheel chairs, oxygen tanks, and canes to maintain their health and wellbeing,” Rep. Price said. “This bipartisan effort seeks to allow providers of this equipment the ability to continue to supply lifesaving medical supplies to patients regardless of where they live.”

 Solid Support out of the Gate

In addition to the bill’s primary backers, 38 lawmakers have attached their names as co-sponsors:

  • Cathy McMorris Rodgers (R-Wash.)
  • Diane Black (R-Tenn.)
  • Marsha Blackburn (R-Tenn.)
  • Rod Blum (R-Iowa)
  • Charles Boustany (R-La.)
  • Bradley Byrne (R-Al.)
  • Chris Collins (R-N.Y.)
  • Kevin Cramer (R-N.D.)
  • Scott DesJarlais (R-Tenn.)
  • Tammy Duckworth (D-Ill.)
  • John Duncan (R-Tenn.)
  • Renee Ellmers (R-N.C.)
  • Bill Flores (R-Texas)
  • Bob Gibbs (R-Ohio)
  • Louie Gohmert (R-Texas)
  • Brett Guthrie (R-Ky.)
  • Gregg Harper (R-Miss.)
  • Andy Harris (R-Md.)
  • Lynn Jenkins (R-Kans.)
  • David Joyce (R-Ohio)
  • Mike Kelly (R-Penn.)
  • Billy Long (R-Mo.)
  • Blaine Luetkemeyer (R-Mo.)
  • Markwayne Mullin (R-Ok.)
  • Tim Murphy (R-Penn.)
  • Kristi Noem (R-S.D.)
  • Collin Peterson (D-Minn.)
  • Mike Pompeo (R-Kans.)
  • James Renacci (R-Ohio)
  • Phil Roe (R-Tenn.)
  • Austin Scott (R-Ga.)
  • David Scott (D-Ga.)
  • Jason Smith (R-Mo.)
  • Glenn Thompson (R-Penn.)
  • Pat Tiberi (R-Ohio)
  • Scott Tipton (R-Colo.)
  • Ann Wagner (R-Mo.)
  • Ryan Zinke (R-Mont.).

“Our champions on Capitol Hill have shared their appreciation for the HME community’s strong grassroots efforts that have helped generate such a strong co-sponsorship list,” AAHomecare President and CEO Tom Ryan said. “Let’s show them that we’re only just getting started!”

“Final passage of this legislation will give the industry time to work with an entirely new administration in 2017 to agree on a long-term solution ensuring that patients in rural America have access to quality medical equipment,” said John Gallagher, vice president of Government Relations for VGM Group, which worked with AAHomecare and other advocates to advance the legislation.

How Providers Can Help

Now that the bill has been introduced to the House, the American Association for Homecare urged providers and industry stakeholders to continue their grassroots efforts by working to swell the nascent legislations number of co-sponsors.

“Ask that your representatives co-sponsor competitive bidding rural relief legislation… 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,” a statement from the association read. “While you should always remain respectful and composed when talking with Congressional offices, please make sure Capitol Hill audiences recognize the urgent nature of this legislation for the HME community.”

Additionally AAHomecare provided additional resources to help providers lobby on behalf of the bill:

Lastly, the association called on providers to attend it’s May 25-26 Washington Legislative Conference, where providers and industry stakeholders will engage in concentrated meetings with lawmakers and staff to advocate on behalf the House and Senate bills.

“We need providers storming the Hill in two weeks,” AAHomecare’s Ryan urged. “This Washington Legislative Conference’s timing is perfect!”

A statement from AAHoemcare noted that after May 26, providers should make plans to follow up with their legislators, who might be available for in-district meetings the following week of May 30-June 3.

More information about the fast-approaching Washington Conference, which will be held at Washington, D.C.’s Washington Court Hotel, is available at bit.ly/2016washconf.

About the Author

David Kopf is the Publisher and Executive Editor of HME Business and DME Pharmacy magazines. Follow him on LinkedIn at linkedin.com/in/dkopf/ and on Twitter at @postacutenews.

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