Bid relief update: Stakeholders target ESRD rule, as pressure mounts

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Friday, May 4, 2018

WASHINGTON – Industry stakeholders say an upcoming rule could be a potential vehicle for changes to Medicare’s competitive bidding program.

Last week, the Office of Management and Budget indicated that the proposed rule, CY 2019 Changes to the End-Stage Renal Disease Prospective Payment System, is under review.

“We talk to the Health and Human Services folks all the time and they have assured us they are working on all of our issues,” said Jay Witter, senior vice president of public policy for AAHomecare. “The ESRD would be the easiest vehicle for them to do it.”

However, like the interim final rule that has been stuck at the OMB since August, there is simply no way to know what’s in the proposed rule for ESRD until it’s published, something that probably won’t happen until the end of June. In previous years, the rule has contained items related to future rounds of competitive bidding, although the most recent iteration of the rule did not.

In the meantime, stakeholders continue to press both HHS officials and lawmakers for the release of the IFR, as well as raise concerns that information and instructions related to Round 2019 are long overdue.

“We’d like to work with them—we’d prefer them to fix the program rather than rush something out,” Witter said. “Lawmakers’ level of concern is growing about all these issues.”

Senate Finance Committee Chairman Orrin Hatch, R-Utah, last week sent a letter to HHS Secretary Alex Azar and CMS Administrator Seema Verma, expressing concerns with the bid program and the national mail-order program for diabetes testing supplies.

One thing providers may not have to worry about: the expansion of the bidding process to all areas of the country, a proposal that was included the 2019 HHS budget. Witter says he has spoken with both Azar and Deputy Secretary Eric Hargan about the proposal.

“It’s in the budget, so they support it, but I got the sense that it’s a proposal that’s not moving forward,” he said.