Advocates Continue Pushing Interim Final Rule

AAHomecare urges providers to replicate MAMES effort to drive adoption of IFR that would resume blended rates for rural providers.

While much of the industry is working to advance co-sponsorship of H.R. 4229, the American Association for Homecare is reminding providers and industry advocates to also urge lawmakers to ask Office of Management and Budget Director Mick Mulvaney to release an Interim Final Rule (IFR) that could bring competitive bidding relief to rural providers and patients.

The IFR, which has been sitting at the Office of Management and Budget since August, would resume the 50/50, blended fee schedule for rural and non-bid areas that was in effect during the phase-in of national bid expansion during Jan. 1, 2016 to June 30, 2016, and apply it to claims submitted between Aug. 1, 2017 to Dec. 31, 2018. It would also exclude home infusion drugs used with HME from competitive bidding.

AAHomecare’s reminder to HME stakeholders comes after a concerted effort by Midwest Association for Medical Equipment Services & Supplies (MAMES) President Patrick Naeger. Efforts by Naeger, executive vice president of Duluh, Minn.-headquartered Healthcare Equipment and Supply Co., resulted in Rep. Blaine Lutkemeyer (R-Mo.) calling Mulvaney on the issue, and Sen. Roy Blunt (R-Mo.) sending a letter to the OMB Director’s office. 

Blunt’s letter (available at asks Mulvaney to approve the IFR, and emphasizes that many of the Senator’s constituents “will have no choice but to transition to full-time skilled nursing facilities if they do not have access to DME that makes it possible for them to remain independent and in their homes for a fraction of the cost.”

“I can't stress enough the need to keep the pressure on at OMB,” Naeger said.  “While the legislative effort is important, we do not have the luxury of time, for we are seeing this industry shrink and many are struggling to stay in business!  We need an all-hands-on-deck approach to figure out who can best influence Director Mulvaney.”

“We’ve heard other reports that both Senate and House members have reached out to OMB to make similar requests thanks to outreach from HME leaders, and we strongly encourage you to ask your legislators to do the same,” noted AAHomecare President and CEO Tom Ryan.

A statement from AAHomecare listed some key discussion points providers can use when calling their lawmakers regarding the IFR:

  • CMS sent the IFR to OMB in August. It would replace the unsustainable full cuts and replace them with the blended rates.
  • The cuts are also negatively impacting beneficiaries of TRICARE, Medicaid, and other payers that base their reimbursement on the Medicare fee schedule. The cuts or many HME products have been by as much as 40 percent to 50 percent.
  • How the cuts are impacting the provider’s business and patients.
  • Then ask the lawmaker to please  contact Director Mulvaney and aski that he approve the IFR.

About the Author

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

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