Moving the HME Industry Forward

Legislative/Advocacy

A New Year Means a Fresh Start for DMEPOS

January 9, 2017

WATERLOO, IA – With the turn of a clock on January 1, the American people move into 2017 committed to those evasive New Year resolutions of getting to the gym more, adding more to their savings accounts, or finally finishing that restoration project.

What the new year will also bring is a new presidential administration and the newly sworn-in 115th Congress, and the pressure is on the federal government to produce results. HME suppliers must take advantage of this transition, which is setting up as a prime opportunity to rally support for providers and the patients they serve.

HME suppliers faced constant challenges and uncertainty within their businesses throughout 2016. From Medicare slashing reimbursement rates to rural America and crushing regulations stemming from an unjust audit process, to the continuation of the flawed competitive bidding program, which has produced unsustainable reimbursements for urban and rural suppliers alike.

While suppliers had the deck stacked against them in 2016, most within the industry believe that the cuts have bottomed out. While the industry has a lot to look forward to in 2017, politics has proven that there are no guarantees. Now begins a fresh start!

Thanks to relationships built at the state and district level with elected officials, the industry is in a much better place. This new reputation of HME can be directly attributed to the countless providers at the grassroots level meeting with their members of Congress, going to town hall meetings, and attending in-district events and calling their offices, which has put a real face on HME.

All that activity has gotten us to this point, but now is not the time to pull up on the reigns, no. Instead, now is the time to continue to educate our members of Congress on the need to go one step further; to finally end the debacle that is the CMS version of “competitive bidding” and replace it with a workable “bidding system” that achieves what Congress is looking for (better pricing), while at the same time allowing providers to do what they do best—take care of patients.

It would be nice to think we could do away with competitive bidding altogether, but in all reality we could never come up with the “pay for” to end it. What then is the next best alternative? Replace it with a system that rewards the three-legged stool of quality care in DMEPOS (patients, providers, and exceptional outcomes).  

So, where are we in the first few days of 2017? We are caught in a void known as the “peaceful transition of power.” In a few weeks, President-elect Donald J. Trump will assume the office of the President of the United States. There are a few key factors that will benefit HME suppliers and their patients following the transition and, more importantly, the confirmation of the new administration.

Regardless of your personal politics, the Trump administration is going to be positive for the industry moving into 2017. Trump has been an outspoken critic of the Affordable Care Act (Obamacare). In combination with a GOP-controlled Congress, the ACA will be repealed and replaced. Depending on the method of repeal, this could be a big win for the industry as it was the ACA that established the cuts to non-bid areas, which could mean that the provision with those cuts vanish.

Secondly, Trump has nominated Rep Tom Price, M.D. (R-Ga) to head the Department of Health and Human Services. Price has been a strong advocate in Congress on behalf of HME providers with a focus on patient-centered health care. Price has sponsored, and led efforts over the last several years, to ensure that HME providers have the necessary resources to deliver the highest quality of care for their patients. In addition, expected CMS administrator, Seema Verma (who has worked closely with state health care issues) is welcome news after providers have dealt with a cold shoulder from the current CMS administration.

While these opportunities to advocate for real, lasting reforms give providers reason to be optimistic, the fight continues onward and won’t happen overnight. Providers must remain engaged with their members of Congress, continue to develop those “grassroots relationships,” and take advantage of any opportunity to make a connection and share stories of why these reforms are crucial to the future of quality health care. In the words of Abraham Lincoln, “Be sure you put your feet in the right place, then stand firm.”

John Gallagher is vice president of Government Relations for The VGM Group, Waterloo, Iowa.