Spending Bill: No H.R. 4229 Provisions Added

While the omnibus budget package didn't include the rural relief bill's legislative language, it does ask CMS to implement the IFR.

• By David Kopf
• Mar 22, 2018

In a tough break for industry advocates, the $1.3 trillion budget package passed by Congress today did not include legislative language from H.R. 4229. That said, the legislation does recommend CMS implement a critical interim final rule (IFR) that might accomplish similar aims.

Industry stakeholders had been engaged in a concerted lobbying push to get the language included in the bill to help protect rural providers and patients. The two key elements of the legislation that would accomplish that are:

• It would roll back the second round of cuts for non-bid area suppliers, effective retroactively to Jan. 1, 2017 and through 2018.
• It bill’s provisions would address rate cuts caused by the misapplication of a 2006 budget neutrality offset balancing increased utilization for oxygen generating portable equipment with lower reimbursement for stationary equipment.

While the spending bill didn’t include H.R. 4229’s provisions, the American Association for Homecare reported that contacts it has on Capitol Hill shared report language accompanying the bill that recommends CMS implement the Interim Final Rule on rural relief. AAHomecare noted that it’s important to remember that the report language wasn’t officially released, but the association had “a high degree of confidence that it is accurate.”

The IFR, which has sat in limbo 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.

“While we are gratified to see that Congress is again asking Federal officials to move the IFR forward, we are also concerned that leaders in the House and Senate have missed this opportunity to provide much-needed relief for home medical equipment providers and patients, especially those in rural America, by failing to include provisions from HR 4229,” said AAHomecare President and CEO Tom Ryan.  “We plan to leverage the omnibus report language to help convince officials at CMS, HHS and OMB to release the IFR or provide some other expedited form of relief for rural suppliers, while also working with our champions in Congress and other influential parties on Capitol Hill to move HR 4229 forward.”

To that end, Ryan emphasized that the push for H.R. 4229's inclusion had paid dividends in helping magnify support for the bill, which the industry can use to advance it as standalone legislation.

“I want to thank the individual suppliers who have stood alongside AAHomecare, other industry stakeholder groups, and organizations representing HME patients in building strong support for HR 4229 and engaging legislators in hopes of getting relief in this omnibus bill,” Ryan said.  “I look forward to working with this passionate and persistent group of advocates to keep the pressure on Congress and the Administration to deliver more sustainable reimbursement rates for our industry.”