Update: On Wedneday, November 30, 2016, the House passed the measure with sweeping bipartisan support. Read more here.
WASHINGTON, D.C. (November 28, 2016)—The latest version of the 21st Century CURES bill to be considered this week on Capitol Hill includes language that would retroactively roll back the second round of Medicare competitive bidding-derived cuts for rural and non-bid area home medical equipment (HME) providers for six months, as well as a provision to further delay the application of bidding-derived pricing for complex rehab technology accessories for an additional six months.
The proposed legislation:
- Extends the transition period for the second part of the bidding-derived cuts from June 30, 2016 to December 31, 2016, paving the way for HME suppliers to recoup those reductions for items with dates of service from July 1 to the end of 2016. The second phase of the cuts that had originally gone into effect on July 1, 2016 would again go into effect on January 1, 2017.
- Delays the application of competitive bidding-derived pricing reductions for complex rehab technology (CRT) accessories used with Group 3 power wheelchairs until July 1, 2017, extending the original 12-month delay granted by Congress in December of 2015.
- Accelerates the application of plans to limit state Medicaid reimbursement amounts for HME to the Medicare fee-for-service payment rates, including applicable competitive bidding rates. While this provision currently is scheduled to take effect in January 2019, the new legislation would move implementation up to January 1, 2018.
- Instructs the Department of Health & Human Services (HHS) to conduct a study on the impact of the bidding program on the overall number of HME providers and availability of HME products over the course of 2016.
- Requires HHS to reissue payment regulations for items and services furnished on or after January 1, 2019, with adjustments to the non-bid fee schedule in some areas based on stakeholder input, costs, volumes and numbers of suppliers serving those areas. This will allow the next Administration an opportunity to provide more permanent relief to rural and non-bid area providers.
“This legislation will help home medical equipment providers in rural areas stay in business and serve their communities while we continue to work for a more realistic and sustainable pricing environment for all HME providers,” said Tom Ryan, president and CEO of the American Association for Homecare. “It’s just the first step in efforts to protect the rural home medical equipment infrastructure, but it’s an important one.”
"This legislation will also ensure that individuals with significant disabilities continue to receive the specialized technology they depend on while we continue to advocate for a permanent fix that will keep CRT accessories outside the purview of the bidding program,” Ryan added. “That’s a very significant development for providers serving a highly vulnerable patient population that depends on these products.”
“We strongly urge the House and Senate to pass this legislation that will allow rural home medical equipment providers and companies furnishing CRT accessories to stay in operation and serve their patients in the coming months while we work towards a longer-term fix,” said Ryan.
“We greatly appreciate the efforts of Congressmen Tom Price (R-Ga.), Dave Loebsack (D-Iowa), and Peter Welch (D-Vt.), as well as Senators John Thune (R-S.D.) and Heidi Heitkamp (D-N.D.) for their tireless leadership on the competitive bidding rural relief issue,” concluded Ryan. “For the provisions related to CRT accessories, Congressman Lee Zeldin (R-N.Y.) and Senators Bob Casey (D-Pa.) and Rob Portman (R-Ohio) deserve recognition for their passionate and effective advocacy. The home medical equipment community looks forward to working with our champions in Congress and the incoming Administration to continue moving in a positive direction on Medicare reimbursement issues.”
The legislation is slated for consideration in the House of Representatives this week, and would likely move to the Senate the following week.
The draft legislative language can be found here. The provisions related to CRT accessories can be found on page 794. The rural relief provisions are shown on pages 795–799.
Visit aahomecare.org for more information.
