House Letter Offers Tool for Regulatory Reform

The Congressional sign-on letter wrapped with 154 signatures, giving Price, Verma leverage for internal bidding reforms at CMS.

The Congressional sign-on letter to Health and Human Services Secretary Tom Price and CMS Administrator Seema Verma calling for regulatory reforms to competitive bidding and CRT accessories wrapped up with a total of 154 signatures attached to it. That support will give Price and Verma leverage for driving internal reforms within CMS, because it demonstrates the desire among House lawmakers to see CMS implement those reforms.

“This letter is different than any other letter we’ve worked on,” said Jay Witter, senior vice president of Public Policy for AAHomecare, during a government update at the recent VGM Heartland Conference. “Most of the time, we’re trying to get the Secretary’s attention. This time we don’t have to get his attention; it’s a tool for him to take to [CMS staff] and say, ‘We have to get this done — Congress wants this.’”

And that legislative will is bi-partisan. All told, there were 50 Democrats signed onto the letter and 104 Republicans. Also, the American Association for Homecare noted that  37 of the signers on the letter are members on key committees of jurisdiction for Medicare reimbursement related issues, the House Energy & Commerce and Ways & Means Committees.

Originally launched by a bipartisan collection of House co-authors including Reps. Cathy McMorris Rodgers (R-Wash.), Dave Loebsack (D-Iowa), Lee Zeldin (R-N.Y.) and Diana DeGette (D-Colo.) the letter (available as a PDF) identifies four key reforms: 

  • Base the blended, 50/50 rate in rural and non-bid areas on the Jan. 1, 2016 pricing, rather than the July 1, 2016 pricing, and extend that pricing structure into 2019.
  • Use the formal rulemaking process to reform competitive bidding to fix a number of flaws in the program.
  • Bring a complete stop the competitive bidding-derived cuts to complex rehab wheelchair accessories, the implementation or which is currently only delayed until July 1.
  • Stop applying a budget neutrality offset to reimbursement for oxygen concentrators in rural and non-bid areas, which was reduced funding for those items to rates below that of competitive bidding rates (the so-called oxygen “double dip”).

Tom Ryan, CEO of the American Association for Homecare credited providers’ and industry advocates’ lobbying efforts during the May 24-25 Washington Legislative Conference in Washington, D.C. for lobbying Representatives to support the letter.

“While the leadership and influence of the principal sponsors on the letter, Reps. Cathy McMorris Rodgers (R-Wash.), Diana DeGette (D-Colo.), Dave Loebsack (D-Iowa) and Lee Zeldin (R-N.Y.), played a major role in marshalling support, it’s clear that the power of a direct, face-to-face appeal to House members or staff was the difference maker in this effort,” Ryan said. “Of the 154 House members on the letter, 119 of those offices were visited as part of May’s legislative conference — 77 percent of the letter’s signees.”


About the Author

David Kopf is the Editor of HME Business.

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