Three members of the U.S. House of Representatives have written and introduced a letter urging the Centers for Medicare & Medicaid Services (CMS) to provide reimbursement relief to preserve Medicare access to durable medical equipment (DME).
In an Oct. 16 bulletin, the American Association for Homecare (AAHomecare) shared the letter, addressed to U.S. Department of Health & Human Services Secretary Xavier Becerra and CMS Administrator Chiquita Brooks-LaSure.
AAHomecare also asked industry stakeholders to urge their representatives to sign onto the letter.
Letter requests reinstatement of the 75/25 blended relief rate
The association said Rep. Marianette Miller-Meeks (R-Iowa), Rep. Paul Tonko (D-N.Y.) and Rep. Randy Feenstra (R-Iowa) released the letter on Capitol Hill on Oct. 16.
“There is a pressing need for relief related to the Medicare ‘75/25’ blended rate for durable medical equipment in non-rural and non-competitive bidding areas,” the letter said. “We request that you act to provide continuity in access to DME for beneficiaries, which has been threatened following the December 2023 expiration of the 75/25 blended rate.
“Specifically, we request that you consider including the 75/25 blended rate for non-competitive bidding, non-rural areas in the calendar year (CY) 2025 proposed rule as well as consideration of temporary 75/25 blended rate relief, since CMS has not yet moved to initiate rulemaking to proceed with DMEPOS competitive bidding.”
The letter also spelled out how inadequate funding for DME ultimately impacts Medicare beneficiaries.
“As you know, interruptions in the supply of DME are harmful to seniors and limit access to life-enabling equipment such as home oxygen. We appreciate that CMS has recognized and addressed such needs in the past, including prioritizing solutions such as permanency for the 50/50 blended payment rate, which has been critical to maintaining access to DME for rural patients.”
DME suppliers under ongoing financial pressures
The letter also emphasized the importance of DME professionals to the health-care continuum.
“DME manufacturers and suppliers continue to play a role in reducing stresses on hospitals and clinicians due to issues from the COVID-19 pandemic,” the letter said. “The DME industry faces ongoing workforce challenges, while working to provide the best care for seniors and individuals with disabilities.”
The authors of the letter contended that DME suppliers are facing intense financial pressures outside of their control, and that Medicare payments haven’t kept up with current events.
“DME suppliers and the patients they serve have faced higher delivery and labor costs due to
Inflation,” the letter said. “We are concerned that CMS, after pausing the competitive bidding program, has not updated payment rates and is still using 2016 pricing methodologies that do not account for
today’s increased costs.
“This is compounded by the expiration of the 75/25 blended rate, which had provided stability by recognizing outdated bid pricing. The 75/25 blended rate policy ensured continued access to DME and related home-care services which are now threatened for millions of Americans. We understand that companies have had to lay off employees and consolidate offices, leaving patients with reduced access and longer wait times for vital care which is often delivered in the home.”
The letter ends with the representatives urging CMS to restore the 75/25 blended relief rate, while also taking “swift action” to create “a permanent, stable and sustainable DME payment system.”
Links to AAHomecare survey results and infographics are included in the letter.
“Please reach out to your Representative in the House and ask them to join the sign-on letter,” the association said in its announcement. “The most effective way to ask for their signature is to reach out to the staffer who handles health-care issues in your representative’s office, share the sign-on letter (by link or as an attachment), and share perspectives on how current reimbursement rates are impacting your company and the patients you serve.”
