Senate Passes PADME

Lawmakers vote to approve legislation that will protect rural HME providers and their patients from bid expansion cuts.

The Senate has voted to approve the Patient Access to Durable Medical Equipment Act of 2016, legislation that would delay the cuts and reform the expansion in several ways.

Sens. John Thune (R-S.D.) and Heidi Heitkamp (D-N.D.) launched the bill, S.2736, into the Senate in March. After accruing co-sponsors over the past few months, the legislation passed through the Senate via unanimous consent.

The bill would:

  • Delay bid expansion’s second round of cuts for HME items in non-bid areas by 12 months, from July 1 until at least July 1, 2017.
  • Lock in the bid ceiling for future rounds of bidding at the levels established at the bid rates in effect on July 1 instead of CMS’ current plan to limit future bid ceilings to the previous bid round 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 Janurary 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 (Jan. 1) to fiscal year 2019 (Oct. 1, 2018).

The American Association for Homecare released a statement thanking Sens. Thune and Heitkamp for leading the Senate effort to pass PADME.

 “Senator Thune and Senator Heitkamp deserve a great deal of credit for their leadership in passing legislation that is critically needed by home medical equipment suppliers and the millions of patients they serve,” said AAHomecare President and CEO Tom Ryan. “This bill will pause a new round of Medicare reimbursement cuts that will impact rural communities throughout the country so that Congress can get a better picture of the effects of previous deep reductions that went into effect on January 1.”

Other industry advocates also celebrated the Senate’s vote, while driving home the stakes that are at play when it comes to applying bidding cuts to small, rural providers and their patients.

“Home medical equipment companies that serve patients in rural and less-populated areas are a lifeline to seniors and people with disabilities or chronic conditions,” said Rose Schafhauser, executive director of the Midwest Association for Medical Equipment Services. “People in rural America are fortunate to have advocates like Senator Thune and Senator Heitkamp who realize that cutting Medicare reimbursement rates to the bone for critically needed equipment and services in these areas without further study is a risk we can’t afford to take.”

“Home medical equipment providers are doing their best to keep patients out of hospitals and long-term care facilities as long as we can,” said Kay Johnson, owner of Midwest Medical Equipment Service in Watertown, S.D., who has advocated for the legislation with members of the South Dakota congressional delegation. “We’re fortunate to have an ally like Senator Thune helping us to continue to serve the healthcare needs of rural communities.”

About the Author

David Kopf is the Publisher and Executive Editor of HME Business and DME Pharmacy magazines. Follow him on Twitter at @postacutenews.

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