Editor's Note

Take the Time to Get Involved

Providers need to carve out some time to urge lawmakers to support legislative initiatives to protect non-invasive ventilators and give relief to non-rural, non-bid area providers.

The average American is constantly fighting wars of attrition. Don’t believe me? Let me give you an example: Earlier this week, the bank where we keep our daughters’ savings accounts tried to charge several fees on those accounts. My wife explained to the customer service rep that the accounts are fee-free until our girls turn 24-years-old.

It was pretty clear from the outset that the CSR was instructed to take my wife through a call flowchart designed to exhaust her. What the CSR didn’t know is that my wife is a Licensed Clinical Social Worker, and it’s her job to get funding for critical care patients and E.R. patients. My wife eats reps like that for breakfast.

I asked my wife how long it took her to crack the CSR. “And hour,” she replied, taking a second to give the rep some credit.

So you’re probably thinking, “who wants to devote an hour to that?” Well, when you added up the monthly fees, multiplied that by three daughters, and then multiplied that by the number of months they had left until they were 24, the total amount the bank wanted to charge was nothing to sneeze at. Let’s just say my wife earned a hell of an hourly.

We all fight these little wars of attrition on a daily basis. Utilities, the cable company, your credit card, the car insurance — whatever the entity, they’re all betting you give up so that they can scrape one more fee out of you, not have to refund you money, or not give some kind of credit due to you.

The same goes for CMS and the HME industry. In the battle against competitive bidding, the industry has had to chip away at what we all know is flawed public policy — for years. And, as the industry succeeds in passing various pieces of legislation, CMS has distorted its interpretation and enforcement of that policy to maintain its war of attrition on HME.

So how do you win? You keep fighting. CMS is betting on you getting worn out and giving up, so the smartest course of action you can take is to join in every industry advocacy push.

You Have Work to Do

Speaking of not giving up, the industry is engaged in another advocacy push, and the effort needs more momentum.

For several weeks now, industry advocates have been urging HME providers and stakeholders to join the grassroots effort to convince lawmakers to co-sponsor the industry’s two bills currently in play, H.R. 2771 and H.R. 4945.

The two bills respectively provide rural and non-bid area relief and remove non-invasive ventilators from competitive bidding. However, the bills have been hovering. Since last week, H.R. 2771 has been stuck at 72 co-sponsors. Similarly, H.R. 4945 only gained one co-sponsor in the last week, bringing its total to 43 backers in the House.

Everyone in the industry needs to take the time to support these two bills. Fortunately, there are two Congressional recesses that will let you request a meeting when Representatives are back in their home districts Feb. 18-21 and March 16-20. 

Here’s some info about both bills to help you advocate on their behalf:

Supporting H.R. 2771

Named the Protecting Home Oxygen & Medical Equipment Act of 2019, H.R. 2771 does three specific things:

  • Permanently implement the blended, 50/50 rural relief rate after 2020.
  • Provides additional relief for non-rural, non-bid areas with a 75/25 blended rate (75 percent competitive bidding rates and 25 percent unadjusted fee schedule rates).
  • Removes the budget neutrality offset for oxygen that was implemented in 2017.
  • To help the providers gain more co-sponsors, The American Association for Homecare provided a list of lawmakers who co-sponsored rural relief legislation in the 115th Congress.

Supporting H.R. 4945

Known as the Safeguarding Medicare Access to Respiratory Therapy (SMART) Act of 2019, H.R. 4945 would keep non-invasive ventilators out of the competitive bidding program.

After a call for public comments drew hundreds of responses from respiratory providers, patient groups, clinicians and caregivers urging CMS not to do so, the agency added non-invasive ventilators to the list of products covered by Round 2021 of competitive bidding.

AAHomecare provided a list of Representatives who joined a sign-on letter asking CMS to reconsider adding the ventilators to competitive bidding to help identify prime co-sponsorship opportunities.

Go to AAHomecare’s Take Action Center to get resources on the issues as well as some solid, how-to information on lobbying members of Congress.

Yes, sending emails, calling, and meeting with members of Congress can seem like a time-consuming pain in the neck, but that’s what CMS is betting on. However, taking the time could gain your business some friends on Capitol Hill, and by sticking it out in this war of attrition, it will pay massive dividends. 

Which reminds me — I have to give my insurance agent a call.

About the Author

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

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