Providers Hit Capitol Hill With H.R. 4229 Topping Their Agenda

Using CMS’s recently released IFR to show the bid system is broken, providers push for broader relief and reforms.

WASHINGTON, D.C. -- With CMS having recently issued an interim final rule that provided limited, temporary rural relief, the American Association for Homecare put broader, longer-term bid relief at the top of its agenda for this week’s Washington Legislative Conference.

Running Tuesday and Wednesday, the event was hosted at the Sheraton Pentagon City in Arlington, Va., but generated meetings at more than 250 Congressional offices on Capitol Hill. Topping the agenda for those meetings was driving increased support for H.R. 4229, the Protecting HOME Access Act, which goes much further than the IFR, according to AAHomecare President and CEO Tom Ryan.

“Now that the IFR is out, we know what the next step is that we obviously need relief in non-bid areas,” Ryan said. “When you compare H.R. 4229 side-by-side with the IFR, you can see that it provides much more comprehensive relief.”

The IFR, released this month, would resume the 50/50 blended rate schedule starting from June 1 through Dec. 31 and will affect rural areas and non-contiguous areas (Alaska, Hawaii and U.S. territories) that are non-bid areas, but not non-bid areas in the contiguous United States. The full text of the IFR can be read here.

In comparison, H.R. 4229 would:

  • 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.

Currently, 145 lawmakers have co-signed their support for H.R. 4229, and securing more backers was a top ask during the conference's legislative meetings.

“We have to continue to get more co-sponsors for that,” Ryan said. “Particularly if you have a Congress member on a committee of jurisdiction. … We want to move this legislation through committee and the more support we get within the committees, such as Ways and Means or Energy and Commerce, the better off we’ll be.”

One upside of the IFR is that, while it provides insufficient and short-term relief, it does help build the case for lobbying on behalf of H.R. 4229, according to Ryan. CMS releases IFRs only when it has immediate problems that must be solved and that's a negotiating point in the industry's favor.

"Finally, there’s an admittance by the agency that [bidding] is a broken system,” Ryan said, adding that industry advocates should use that as a reason to convince lawmakers to back H.R. 4229.

About the Author

David Kopf is the Editor of HME Business.

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