Bid relief 'in the mix'

WASHINGTON - Amid the chaos in Washington, D.C., industry stakeholders have been crisscrossing the Hill to ensure relief from Medicare's competitive bidding program doesn't get lost in the shuffle.

Members of AAHomecare, The VGM Group and others made at least 16 visits in two days last week, and also have spoken with the office of House Speaker Paul Ryan.

“The feedback from Speaker Ryan's staff is that it's in the mix, but they can't give us a specific vehicle or any clarity to the issue,” said Jay Witter, senior vice president of public policy for AAHomecare. “He's still negotiating with his caucus. There's all sorts of people vying for power.”

Ryan in September offered assurance that bid relief would be taken up in the lame-duck session, which may end sooner rather than later on Dec. 9.

As to a vehicle, there are a few opportunities, say stakeholders.While it looks unlikely that there will be any sort of Medicare package passed before the end of the year, stakeholders say language addressing bid relief could get included in the 21st Century Cures Act or in an omnibus spending bill.

In lieu of an omnibus bill, lawmakers could pass a continuing resolution to keep the government funded through March. That would, however, lessen the industry's chances of being included, because House Republicans have indicated they would like the CR to be “clean,” stakeholders say.

“This is a critical time,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “Decisions are being made and as soon as they come to an agreement on the budget, that's going to drive the timing. Then things will happen very, very quickly.”

Another less likely option, say stakeholders: getting legislation passed by unanimous consent. In July, the Senate began a “hotline process” to pass an amended version of H.R. 5210, which had already been passed by the House of Representatives earlier in the month, but that effort failed.

“That's the most difficult play,” said Tom Ryan, president and CEO of AAHomecare.“We have gotten everybody lined up and we continue to lobby.”

In their conversations with lawmakers since the elections, stakeholders are hearing that grassroots efforts to raise the noise level are making it to the ears of lawmakers. A new weapon in the toolbox: data highlighting a 39% decrease in PTANs and a 37% decrease in tax ID numbers for HME providers, said Ryan.

“That was an 'a-ha' moment for many of the legislators,” he said. “There's significant loss in the infrastructure of this industry and they said they want CMS to respond to those statistics.”