AAHomecare Urges Continued H.R. 4229 Advocacy

Bill remains an essential element in the strategy to obtain relief for rural providers and patients; association calls on providers to lobby lawmakers.

As the industry works to achieve rural relief via advancing the interim final rule (IFR), the American Association for Homecare urged providers to also continue lobbying to drive increased support for H.R. 4229.

The bill has two main thrusts:

  • It would effectively roll back the second round of cuts for non-bid area suppliers, effective retroactively to January 1, 2017, and through 2018.
  • It 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 industry advocates and lawmakers continue to urge Office of Management & Budget (OMB) Director Mick Mulvaney to release the rural relief IFR, which would implement provisions similar to H.R. 4229, the industry is also urging providers to drive increased Congressional support for the bill.

“While getting a significant measure of relief through the IFR or similar regulatory action would certainly be welcome news for the HME community, there is no guarantee that action will be coming or that it will be as substantial as we desire,” a statement from AAHomecare read. “It’s imperative that we also continue to build support for H.R. 4229 to make sure we have another avenue for relief if the Administration fails to provide it!”

Reps. Cathy McMorris Rodgers (R-Wash.) and Dave Loebsack (D-Iowa) launched H.R. 4229, the Protecting HOME Access Act, and the bill is currently at 141 co-sponsors. Providers can see if their Representative is a co-sponsor by visiting bit.ly/2hBxh4c.

“If your legislator is not currently among the list of co-sponsors, please call or email the legislative assistant who handles healthcare issues and ask that they sign on as a co-sponsor of H.R. 4229,” the AAHomecare statement noted. “… If you are coming to D.C. for the Washington Legislative Conference, please let your legislators know that you plan to discuss the issue in person with them next month.”

To identify and reach your member of the House of Representatives, call the U.S. Capitol Switchboard at (202) 224-3121 or search online at www.house.gov.

AAHomecare suggested providers make the following points in their advocacy calls:

  • The legislation provides a measure of relief for rural HME providers who have seen Medicare reimbursement rates for many popular HME items slashed by 50 percent or more since January 2016.
  • The rates, derived from the flawed competitive bidding program, do not take into account the higher costs associated with serving geographically distributed patients in rural communities lacking the healthcare infrastructure and support found in urban areas. 
  • The legislative language would also remedy additional rate cuts for oxygen in rural areas caused by an outdated 2006 budget neutrality offset balancing increased utilization for oxygen generating portable equipment with lower reimbursement for stationary equipment.
  • According to a 2017 survey of Medicare beneficiaries, case managers/discharge planners, and home medical equipment suppliers, the bidding program has negatively affected beneficiaries’ access to HME, adversely impacted case managers’ ability to coordinate HME for their patients, and placed additional strain on suppliers to deliver quality products without delay. Detail from Access to Home Medical Equipment: Survey of Beneficiary, Case Manager, and Supplier Experiences is available via the executive summary and complete study.
  • The cuts are also impacting rates for Medicaid, TRICARE, Medicare Advantage plans, and other payers who tie their reimbursement to Medicare’s fee schedule.
  • Describe how the cuts are affecting your business and your ability to serve HME patients in your community. Note any closings or cutbacks in services by other HME suppliers in your area.


About the Author

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

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