Chip, chip, chip

Earlier this month, Managing Editor Theresa Flaherty and I were trying to piece together the latest developments in reimbursement relief and we were both getting pretty frustrated.

AAHomecare announced recently that the industry's champions in the House of Representatives had introduced H.R. 8158, a bill that would eliminate the budget neutrality requirement for home oxygen therapy. The association says the House Energy and Commerce Committee requested that the provision be peeled away from the other provisions in H.R. 2771 - those other provisions being, making permanent the 50/50 blended reimbursement rates in rural areas and introducing a 75/25 blended reimbursement rate in non-rural, non-bid areas.

The committee chose to separate the budget neutrality provision, because it knew that the other provisions would weigh it down, especially since those other provisions are technically already in place through the end of the year (50/50) and through the PHE (75/25).

Where we got frustrated - besides keeping track of it all - was with this approach of chipping away at bad policy.

Industry stakeholders and their champions have become accustomed to this approach. The blended rates in and of themselves are an attempt to chip away at competitive bidding rates that are unsustainable, particularly in rural and non-rural, non bid areas.

Then take accessories for complex rehab wheelchairs. CMS did away with bid pricing for accessories for complex rehab power wheelchairs, but then the agency said its hands were tied when it came to manual wheelchairs because of a technicality. Stakeholders and their champions were able to pause bid pricing for accessories for complex rehab manual wheelchairs for 18 months - chip, chip, chip - and now they're trying to make that permanent.

See, frustrating.

But as Cara Bachenheimer told me, something is better than nothing, and in the case of the H.R. 8158, it's a “huge step” to ameliorate a requirement that has created a “double dip” reduction in reimbursement for oxygen.

And it's really a testament to stakeholders - not only AAHomecare, VGM, and state and regional associations, but also the providers that are making the calls and sending the emails - and their champions in Congress that we're here. They won't stop chipping away, breaking up bad policy until what's left, when put back together, has some semblance of sustainability.