House Passes Cures Bill

The 21st Century Cures Act provides six months of retroactive relief for rural providers suffering from national bid expansion.

The House of Representatives has passed the 21st Century Cures Act, which includes provisions that will help give relief to providers affected by the national expansion of competitive bidding.

The Senate is expected to pass the Act next week, and the Obama Administration said it supports the legislation, which would indicate the bill’s likelihood to be signed into law by the President. 

The Cures Act provides retroactive relief to non-bid providers by extending the initial phase of partial reimbursement cuts to impacted items from June 30 to Dec. 31, and pushing 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.

“This legislation will help home medical equipment providers in rural areas stay in business and serve their communities while we continue to work for a more realistic and sustainable pricing environment for all HME providers,” American Association for Homecare President and CEO Tom Ryan said. “It’s just the first step in efforts to protect the rural home medical equipment infrastructure, but it’s an important one.”

Other key provisions:

  • 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.

The bill’s pay for 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.

The full legislative language can be found at http://bit.ly/2fRK7Yf, with the provisions related to CRT accessories found on page 794, and the rural relief provisions found on pages 795 to 799, according to AAHomecare.

Ryan thanked a number of key lawmakers who helped shepherd the HME-related provisions through the legislative process.

“We greatly appreciate the efforts of Congressmen Tom Price (R-Ga.), Dave Loebsack (D-Iowa), and Peter Welch (D-Vt.), as well as Senators John Thune (R-S.D.) and Heidi Heitkamp (D-N.D.) for their tireless leadership on the competitive bidding rural relief issue,” he said. “For the provisions related to CRT accessories, Congressman Lee Zeldin (R-N.Y.) and Senators Bob Casey (D-Pa.) and Rob Portman (R-Ohio) deserve recognition for their passionate and effective advocacy. The home medical equipment community looks forward to working with our champions in Congress and the incoming Administration to continue moving in a positive direction on Medicare reimbursement issues.”

About the Author

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

The Key to Patient Engagement