Moving the HME Industry Forward


Advocacy Priorities for April and May Come into Focus

April 14, 2018

HME stakeholders are encouraged to engage their legislators in the upcoming weeks to keep up the pressure on HHS & CMS to move the IFR and to include long term bidding reforms in the next round of bidding. Specifically, we’re asking the HME community to deliver these messages to Capitol Hill:

1) Following Up on the Omnibus Bill: Recent Omnibus report language “encourages CMS to promulgate the pending Interim Final Rule entitled Durable Medical Equipment Fee Schedule, Adjustments to Resume the Transitional 50/50 Blended Rates to Provide Relief in Non-Competitive Bidding Areas.” Please contact CMS and ask that they expedite release of the IFR or take similar action that provides timely and substantive relief for home medical equipment suppliers in non-bid areas.

2) Next bidding round: As CMS/HHS prepares for the next bidding round, we urge you to include these common-sense reforms to ensure more accurate price discovery and to ensure patient access to HME products and services:

  • Use market clearing price to determine Single Payment Amount for any item included in competitive bidding.
  • Use historical claims data to determine supplier capacity.
  • Increase transparency of the competitive bidding program.
  • Reform competitive bidding product categories.
  • Remove CMS’ authority to move forward with bundled payments for CPAP and standard power wheelchairs.

3) Implementing CURES provisions: Dec. 2016 CURES legislation required CMS/HHS to reissue payment regulations for items and services furnished on or after January 1, 2019, with adjustments to the non-bid fee schedule in some areas based on stakeholder input, costs, volumes, and numbers of suppliers serving those areas. Please provide an update as to how the Agencies are substantively addressing this guidance.

AAHomecare will be providing sample letters and guidance for you to use on these issues with your legislators in the coming weeks.

We hope to generate significant momentum and awareness for these messages (and also continue to build support for HR 4229) in the weeks running up to the Washington Legislative Conference, May 23-24. With mid-term elections on tap for this Fall, it’s critical that we get Congress’ attention this Spring and early Summer.