Moving the HME Industry Forward

Legislative/Advocacy

AAHomecare Wraps Legislative Conference, Delays Medicaid Cuts

June 1, 2015

WASHINGTON, DC – Last week’s AAHomecare Washington Legislative Conference continued industry momentum with key relationships renewed and a growing understanding among lawmakers about the challenges faced by HME providers.

“This was the most pleasant visit I have experienced in 40 consecutive years of lobbying for our industry,” enthused Michael Hamilton, executive director of the Alabama Durable Medical Equipment Association. “We were warmly greeted at every office, and our national association was not only well known, but highly regarded and respected by every person to whom we spoke. AAHomecare has worked miracles in the past few years.

“Our industry is no longer considered the heart of ‘fraud-and-abuse,’ but is considered a vital part of the health care delivery system,” continued Hamilton. “Other than concerns about CBO scores, no one turned down the possibility of supporting or cosponsoring our measure to further the issues we discussed—rural bid rate rollout, audit reform and expanding prior authorizations.”

Medicaid Cuts Delayed
On May 22, the House Energy and Commerce Committee unanimously passed the 21st Century Cures legislation, the goal of which is to foster healthcare innovation. The bipartisan support reflected in the 51-0 vote in favor of the bill came after lawmakers hashed out an agreement on ways to offset its estimated $13 billion cost. While the Cures bill has strong support in the House, it does not appear to have the support needed to pass in the Senate.

Over the previous week, as the Committee considered provisions to help pay for the legislation, AAHomecare was advised that one of the “pay-fors” would affect Medicaid patients’ access to home medical equipment (HME). The provision being considered would limit the federal portion of state Medicaid fee-for-service rates for HME to the Medicare bid program rate, an idea that has been proposed in the President’s budget for the last six years.

AAHomecare immediately began taking meetings with Energy and Commerce Committee leaders to articulate the business and patient care concerns related to these cuts and to build support for the removal of this provision from the bill. As a result, AAHomecare negotiated a delay of the cuts back to 2020 from the original start of 2016, thus reducing the score to $2.8 million. AAHomecare will continue to defend against the inclusion of these cuts to Medicaid HME rates in any future iterations of this bill.

As part of these discussions, AAHomecare was asked for a budget neutral proposal that would help improve the HME benefit. A nationwide prior authorization process would help address audit problems, and AAHomecare is working to have prior authorization language added to the Cures Bill before it reaches the House floor.

Energy and Commerce Chair Fred Upton (R-MI) is not optimistic about the bill making it through the other chamber in its entirety. “The Senate’s never going to pass a bill this big, we know that,” said Upton. Upton noted he is looking for the Senate to pass “an innovative medicine piece” or something a little bit broader.

Before the Cures Bill moves forward, it will need to be discussed in the Appropriations, Budget and Rules committees prior to an expected House floor vote in late June.