ATLANTA (October 27, 2015)—On January 1, CMS plans to expand competitive bidding program rates to rural America. If it happens, rural providers would face a reimbursement reduction of up to 45 percent in most areas.
In the short term, John Gallagher, vice president of Government Relations at VGM & Associates, is urging providers to get patients involved in grassroots efforts by asking lawmakers to stop the rural rollout. Specific legislation has not yet been introduced, but is likely to come soon.
Gallagher made the remarks during a presentation on day one of Medtrade at the Georgia World Congress Center in Atlanta. Another priority for the industry is getting recently passed binding bids legislation to kick in (through an appropriations strategy) during the earlier part of the required window, which stretches between 2017-2019.
“The language says no sooner than 2017, and no later than 2019,” explained Gallagher. “Why is 2017 so important? Because you are already looking at 2018 for the re-bid, and 2019 would be right behind it. So CMS would get two more bids, with suicide bids in there, if they were able to push it back to 2019.”
In the long term, Gallagher is keeping a close eye on government plans to apply Medicare competitive bidding rates to Medicaid. “We’ve got to make sure that doesn’t happen,” he said.
Catherine A. Hamilton, chief financial officer at Coastal Med Tech Inc, Hermon, Me, attended the Gallagher presentation, and expressed considerable concern about the impending rural rollout. “We are shell-shocked by it,” she said. “The rollout is a nightmare…We would have to take a large loss, and may not be able to serve oxygen patients with POCs or tanks. It [proposed rollout] is not sustainable.”
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