Comments in hand, industry ready to roll on broader relief

WASHINGTON - Industry stakeholders feel they have a “fair shot” at getting broader reimbursement relief for HME providers in all non-competitive bidding areas, rather than in the limited areas proposed by CMS.

In comments submitted last week on a recent proposed rule, AAHomecare urged CMS to apply 50-50 blended rates not only in rural and non-contiguous areas from Jan. 1, 2019, through Dec. 31, 2020, but also in the remaining non-bid areas.

“It was mentioned in the interim final rule as a possibility, and the proposed rule suggested they considered it but wanted more comments on that, which I think kind of set the table,” said Tom Ryan, president and CEO of the association. “We also talked about the 21st Century Cures Act and the intent of Congress, which is that the relief would be more broad. For all those reasons, I feel optimistic we can get there.”

AAHomecare also recommends that CMS establish rates in the former bid areas at the current SPA rates but provide an increase to those rates by all the CPI-U increases from 2013-18.

With AAHomecare's comments now submitted, the race is on to educate lawmakers.

“It's complicated and there are not a lot of details,” said Cara Bachenheimer, chair of the government affairs practice at Brown & Fortunato. “We need to educate our allies, staff and leadership of the committees of jurisdiction. Hopefully, they can echo similar concerns and make similar recommendations, as well. That's really the goal.”

Stakeholders have been laying the groundwork for broader relief all along, says VGM's John Gallagher, who, along with a group of providers, met with rep. Cathy McMorris Rodgers, R-Wash., earlier this month, and will meet with Rep. Greg Walden, R-Ore., chairman of the Committee on Energy and Commerce on Aug. 27.

“McMorris Rodgers wants to sit down with CMS and really go over the impact of the program and possible regulatory fixes,” said Gallagher, vice president of government relations. “Along with the recent letter from West Virginia—we are trying to get similar letters from Iowa, Montana and hopefully Kentucky—if we can get those raising questions, that's what we want to happen.”

Providers need to speak up too, say stakeholders. For its part, VGM has created a template that breaks down five of the main proposals in CMS's proposed rule.

“All you've got to do is add in specific paragraphs on how it impacts you in, say, Raleigh-Durham, N.C.,” said Gallagher. “Then, just fire it off by email or mail.”

Comments are due Sept. 10 and a final rule is expected around Nov. 1.