With no time to lose, HME industry stakeholders are ready for another run at the competitive bidding program.
Legislation in the works by Sen. John Thune, R-S.D., would delay the next round of cuts for nine to 12 months, depending on the CBO score.
“This proposal is fresh and new,” said Jay Witter, senior vice president of government relations for AAHomecare during the association’s legislative update at Medtrade Spring in Las Vegas last week. “There will be a bill here shortly. We need your help and we need it quickly.”
On Jan. 1, CMS implemented the first round of cuts* in regional and rural areas, basing reimbursement on a 50/50 blend of the current and adjusted rates. On July 1, reimbursement will be based only on the adjusted rates.
The plan is to get a bill introduced and passed through an expedited “hotline” process.
“The window of opportunity in this crazy election year is very small,” said Tom Ryan, president and CEO. “This is what’s in front of us today—we can’t go back.”
The pay-for for the bill: Move up the start date of an already planned Medicaid cut from calendar year 2019 (Jan. 1, 2019) to fiscal year 2019 (Oct. 1, 2018). The cut will match the federal portion of Medicaid allowables to adjusted Medicare reimbursement.
Other provisions in the bill: a ceiling for future rounds of competitive bidding set at the unadjusted fee schedule rates as of Jan. 1, 2015; and a requirement that CMS revisit adjusting pricing for non-bid areas that takes into account travel distance, clearing price and other associated costs for furnishing equipment that will be in effect Jan. 1, 2019.
“Our champs in the Senate are lining up allies,” said Witter. “(Rep. Tom Price, R-Ga.,) is raring to go in the House.”
Stakeholders are also working with Senate members to ask CMS to fix the bidding program without forcing the issue through legislation.
“Our contention is that CMS can do this on their own,” said Witter. “We have a number of heavy hitters on our side.”