Push for HR 4229 Provisions in Omnibus Bill Intensifies

With March 23 deadline to keep the government funded looming, HME advocates push hard to get rural relief provisions integrated into appropriations bill.

• By Joshua Bolkan
• Mar 15, 2018

About a week remains before Congress must pass an omnibus spending bill to keep the government funded, the industry’s lobbying push is on to get provisions from another bill, HR 4229, that protect rural HME providers, inserted into the larger spending legislation.

HR 4229 would roll back cuts to suppliers in non-bid areas, retroactively eliminating the cuts back as far as Jan. 1, 2017 through the end of this year and would mitigate rate cuts stemming from the misuse of a 2006 budget neutrality offset that lowered the reimbursement for stationary oxygen equipment.

With 128 cosponsors for HR 4229 already, the bill's provisions seem to be a likely fit for the omnibus bill. To that end, AAHomecare advocates and a team from the Kentucky Medical Equipment Suppliers Association (KMESA) met with Kentucky's congressional delegation earlier this week, including a sit-down with Senate Majority Leader Mitch McConnel (R-Ky.) on Tuesday morning.

Tom Ryan, president and CEO at AAHomecare, and Jay Witter, senior vice president of public policy at the organization, were joined by KMESA President Jason Orr and former KMESA President Thad Connally to ask McConnell to support inclusion of the bill's provisions in the spending bill.

"In addition to reinforcing the need for relief with Sen. McConnell and several other influential Kentucky legislators, these meetings are also providing very useful intelligence for our lobbying team and other HME stakeholders who are active in this effort," Ryan said in a prepared statement. "We've got an uphill fight to get our provisions into the upcoming spending package, but powerful advocacy work like this impromptu fly-in, coupled with tremendous co-sponsor support the HME community has generated for HR 4229, increases our chances for success.  I hope these KMESA leaders' visit will help inspire HME suppliers everywhere to keep fighting to get these provisions in the appropriations bill, and to join us for the AAHomecare legislative conference and fly-in in May."

The Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition also threw support behind inclusion of the 4229 provisions earlier this week in the form of a letter to leadership of both parties in both houses of congress. The letter, which ITEM has made available for individuals to include in communicating their support for 4229's provisions to lawmakers, also urges Congress to include provisions from HR 3730, which would exclude manual CRT devices from bidding and more.

Ryan has also recently called for a public push to support the provisions in a recent message posted to the AAHomecare site. In the message, Ryan offers a list of members of the appropriations committee for targeting in both the Senate and the House, along with suggested language for a letter:

"Please include provisions from H.R. 4229, the Protecting HOME Access Act, in the next round of budget legislation. This bill would provide relief for durable medical equipment providers in rural areas facing drastic and unsustainable Medicare reimbursement cuts and would also roll back unsustainable cuts for providers in all communities — urban, suburban, rural — who serve TRICARE and Medicaid beneficiaries.  Without this relief, we're at risk of losing an important part of the infrastructure that serves seniors and people with disabilities and helps lessen the need for hospitalizations and other costly clinical interventions."