Lawmakers Intro Bill to Boost DME Reimbursement

New House legislation would help increase reimbursement by 10 to 15 percent for 13 categories that CMS pulled from Round 2021.

Reps. Markwayne Mullin (R-Okla.) and Paul Tonko (D-N.Y.) have launched legislation in the House of Representatives that would increase Medicare reimbursement rate for items in former Competitive Bidding Areas.

The DMEPOS Relief Act of 2022 would apply 90/10 blended Medicare reimbursement for items in the 13 product categories CMS did not award contracts for in Round 2021 of competitive bidding. The increased rates would apply to claims from Jan. 1 to Dec. 31, 2023.

“In my district, many of these small businesses are the only suppliers of home medical equipment for miles. They must stay in business to ensure patient access,” Mullin said in a public statement. “Rural areas already face unique challenges when it comes to quality health care. Access to HME, such as oxygen tanks and walkers, is critical for patients to continue living out their daily lives from the comfort of their homes.”

“Now more than ever, Americans need access to affordable home medical equipment, but outdated reimbursement rates for lifesaving medical equipment is making it increasingly difficult for small businesses to deliver that vital care,” Tonko said in the statement. “I’m proud to join Congressman Mullin to introduce bipartisan legislation that will address the rising cost of care and will help ensure that our seniors and all patients are supported.”

The HME industry has seen a 50 percent reimbursement cut since 2016. The legislation’s estimated 10-15 percent increase in current reimbursement rates would help address the rising costs providers are experiencing due to the Covid-19 pandemic, narrowed supply chains, and inflation.

“This legislation will help bring rates and market realities in line and allow suppliers to continue to support seniors and other vulnerable patients at home,” said Tom Ryan, president and CEO of the American Association for Homecare. “We thank Congressmen Mullin and Tonko for spearheading this legislation and recognizing how high-quality, home-based care can deliver better patient outcomes while reducing overall healthcare costs.”

Other Representatives joining the bill as original co-sponsors include Brian Fitzpatrick (R-Pa.), Fred Keller (R-Pa.) Frank Mrvan (D-Ind.), Tom Reed (R-N.Y.), and Terri Sewell (D-Ala.).

AAHomecare’s Ryan added the effort to back the bill and attract more co-sponsors is now underway.

“This new legislation is an opportunity to secure a meaningful increase for Medicare reimbursements covering major HME product lines,” he said. “We have to go all-in on advocacy efforts to make sure Congress understands the need to pass this legislation and invest in cost-effective and clinically proven home-based care. That campaign starts now.”

AAHomecare has made a draft of the bill available as a downloadable PDF.

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