WASHIGTON, D.C. (August 11, 2022)—The Centers for Medicare & Medicaid Services (CMS) is not planning substantial rulemaking to set a new round of home medical equipment competitive bidding in motion, the American Association for Homecare (AAHomecare) said in a press release.
AAHomecare senior staff met with CMS leaders last week for an update on the agency’s plans for future bidding rounds and to make the case for home medical equipment (HME) reimbursement policy priorities. Jason Bennett, acting director of CMS’s Technology, Coding and Pricing Group, led the CMS delegation on the productive Zoom session.
While the prospect of continuing open access to HME products in former competitive bidding areas (CBAs) should cheer suppliers, patients and clinicians alike, said AAHomcare, reimbursement rates based on bids from seven years ago continue to hamper the HME industry.
In the meeting, AAHomecare stressed the need for a meaningful adjustment for reimbursement rates that reflect the market realities that suppliers are facing in the wake of both broad-based inflation as well as increased product and operational costs specific to health care providers and HME in particular. To illuminate that case, AAHomecare shared a timeline on former CBA reimbursement history and changing costs since the last completed and implemented bidding round in 2015. AAHomecare also advocated for extending the 75/25 blend for nonrural, nonCBA suppliers beyond the end of the COVID-19 public health emergency (PHE).
In addition, the association asked CMS to help ensure that audits on claims filed during the PHE do not trigger improper denials based on the wide range of waivers in place during that period. Leadership also specifically requested CMS allow for patients that received a continuous glucose monitor during the PHE to continue to receive related supplies post-PHE, as many of the individuals who qualified under the waivers during the pandemic will not qualify when the PHE finally ends.
AAHomecare said that their CMS counterparts appear to understand and appreciate the challenges that the HME community is facing.
The association is asking members to continue to engage Capitol Hill on Medicare reimbursement priorities in the hopes of securing substantial relief at the legislative level, or to generate Congressional pressure on CMS on these issues.
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