HME Advocates Discuss IFR with HHS

AAHomecare and other industry representatives discuss the rural relief IFR and bid reforms with HHS, CMS officials.

Two weeks ago, American Association for Homecare representatives told attendees of its March 28 Medtrade Spring Washington Update that it would follow up with CMS regarding lawmakers’ encouraging the agency to implement the rural relief IFR, and it looks like they’re making good on their word.

Today, AAHomecare President and CEO Tom Ryan and Vice President of Public Affairs Jay Witter, along with Cara Bachenheimer, senior vice president of Government Relations for Invacare, and Christian Springer of legal and lobbying firm Foley Hoag, met with HHS Deputy Secretary Eric Hargan and other HHS and CMS officials to discuss the IFR, as well as other issues.

After hovering in limbo at the Office of Management and Budget since August, the IFR re-gained momentum when the $1.3 trillion budget package passed by Congress on March 22 did not include language from rural relief bill H.R. 4229 but did recommend that CMS the IFR.

Specifically, the IFR 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 and Dec. 31, 2018. It would also exclude home infusion drugs used with HME from competitive bidding.

A statement from AAHomecare noted that the industry advocates would underscore “Congress’ call for quick action on the IFR that was part of the recent Omnibus budget legislation.” 

Other topics discussed in the meeting, according to AAHomecare, included:

  • An update on the status of the next competitive bidding round.
  • Long-term reforms for the bidding program.
  • The status of provisions from the 2016’s CURES legislation that directed CMS to use stakeholder input, travel and cost considerations, and other local data in making cost adjustments in non-bid areas starting in January 2019
  • Concerns about language in the 2019 White House Budget proposing a bidding program for current rural/non-bid areas.

April and May Advocacy Priorities

To bolster the meeting, AAHomecare called on industry stakeholders to lobby their lawmakers to urge HHS and CMS to do three things:

First, promulgate the IFR, or “take similar action that provides timely and substantive relief for home medical equipment suppliers in non-bid areas.”

Second, integrate specific long-term bidding reforms into the next round of bidding. The reforms aim to ensure more accurate price discovery and to ensure patient access to HME products and services:

  • Use the market clearing price to determine Single Payment Amount for any item included in competitive bidding.
  • Use historical claims data to assess supplier capacity.
  • Increase transparency of the competitive bidding program.
  • Reform competitive bidding product categories.
  • Remove CMS’ authority to proceed with bundled payments for CPAP and standard power wheelchairs.

Third, provide an update on how it plans to implement the Dec. 2016 CURES Act provision that requires CMS/HHS to adjust the non-bid fee schedule for items and services furnished on or after Jan. 1, 2019. CMS is supposed to base the adjustments in those areas on stakeholder input, costs, volumes, and numbers of suppliers serving those areas.

AAHomecare says it will provide sample letters and guidance to use as part of the lobbying effort in the coming weeks. The hope is that effort will also help set the stage for AAHomecare’s May 23-24 Washington Conference.

“We hope to generate significant momentum and awareness for these messages (and also continue to build support for H.R. 4229) in the weeks running up to the Washington Legislative Conference,” AAHomecare’s Ryan said. “With mid-term elections on tap for this Fall, it’s critical that we get Congress’ attention this Spring and early Summer!”

About the Author

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

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