Congress is currently on its annual summer recess until after Labor Day. This provides a great opportunity to schedule a local office meeting or, better yet, a site visit for your Representative or Senator to visit your company to educate them on your business, the Medicare processes from intake to delivery and the challenges of providing beneficiaries the products and services they need. The entire House of Representatives and one-third of the Senate is up for re-election this November, so getting an appointment with them during August should be easier than in a non-election year, as they are interested in securing your support on Election Day. This is an optimal time to get their attention and secure their commitment to support our industry’s priorities. The primary issues pending congressional action that will require continued grassroots advocacy to secure additional support include legislation to provide relief in future rounds of competitive bidding, audit reform and separate recognition of complex rehab technology under Medicare. Here is a guide to assist you in advocacy efforts of priority issues. Competitive Bidding—H.R. 4920, the “Medicare DMEPOS Competitive Bidding Improvement Act of 2014,” introduced June 19 by Reps. Pat Tiberi (R-OH) and John Larson (D-CT) has bipartisan support. The bill would make future bids binding by requiring a bid bond that converts to a performance guarantee if awarded a contract at or above their composite bid amount. If a contract winner fails to perform under the contract, both the bid bond and the provider’s surety bond would be triggered, resulting in a loss of their Medicare supplier number. It also requires CMS to verify state licensure requirements up front. In addition, it is important to share with your Representative and Senator’s office the impact of the bidding program on your company and those you serve. Audit Reform—Representative Renee Ellmers (R-NC) and Representative John Barrow (D-GA) introduced DME Audit Reform legislation in July to improve the audit process. Specifically the bill requires Medicare contractor transparency and reporting; restores use of clinical inference and clinical judgment when evaluating audits; limits documentation review periods to three years for all Medicare audits; requires the DME MACs to conduct outreach and education programs for suppliers, physicians and referral sources to lower error rates. This provision will force CMS to have transparent and uniformed rules; provides incentives for DMEPOS suppliers who have low error rates—suppliers with low error rates will have their audited claims reduced; and DMEPOS suppliers with a 15 percent or lower audited claims error rate will be subject to only one claim audit a year.
Separate Recognition of Complex Rehab Technology
The “Ensuring Access to Quality Complex Rehab Technology Act of 2013,” H.R. 942 and S.948 have gained significant bipartisan support during the last few months. This legislation is well positioned to move late this year if a Medicare vehicle moves, which is most likely after the elections. Call to schedule a site visit or meeting today. The latest position papers and supporting materials on the three priority issues can be found at aahomecare.org and access2crt.org.
