Providers Sound Off of CURES Act Call

Providers and HME stakeholders flooded onto a special CMS conference call to describe how competitive bidding-derived reimbursement cuts were impacting their businesses and patients, particularly in rural areas.

The call, held on March 23, was required by the CURES Act, which mandated that CMS solicit and take into account stakeholder input — especially feedback from rural providers — on a variety of factors that the agency should then incorporate into how it adjusts fees in non-competitive bidding areas, beginning in 2019.

In addition to factoring in considerations such as the highest amount bid by a winning supplier in a competitive bidding area, CMS must also compare various factors with respect to non-competitive bidding areas versus competitive bidding areas, such as:

• Average travel distance and costs associated with furnishing DME/HME items and services in an area.
• Average volume of items and services furnished by suppliers in an area (which can be considerably lower for rural providers, for instance).
• The number of suppliers in an area.

And that’s exactly what providers on the call did. Some of the replies from the conference call:

“…When your cost exceeds the reimbursement, there’s a problem, and these people are going to go without,” noted Julia Humphrey of Reno, Nev. Respiratory provider Accellence Home Medical. “And that’s my biggest concern at this point. I don’t know how you can possibly service these rural areas for the fee schedule that we’re receiving at this point.”

“…We deal with the rural areas not just here in central Virginia but across the Blue Ridge Mountains,” said Ronnie Rankin of Culpeper Home Medical in Culpeper, Va. “Some of clients are hours, an hour and a half away. And that is only if you don’t account any weather, which is pretty common with the mountainous area.”

“These prices were implemented for an area where the bid winners would see highly increased volume, so that they could give Medicare much reduced pricing,” said Josh Shieldsof Beta Med in Bryan, Texas. “In the rural areas, we do not see that increase in volume.”

All in all, providers exhausted the call’s feedback time (read the 34-page transcript), but providers who were unable to leave their feedback or could not attend the call can still give CMS their feedback via email Providers should send CMS email comments to [email protected] no later than April 6. 

Gordon Barnes, director of communications for the American Association for Homecare has asked that providers also send their comments to him at [email protected] so that his association can use them in its advocacy efforts (Barnes assures that AAHomecare will not share any identifiable details from those comments without first obtaining that provider’s permission). 

More information about CMS’s efforts to collect provider feedback and data is available at http://go.cms.gov/2oFoJud.