Industry ramps up political pressure

WASHINGTON - A “Dear Colleague” letter making the rounds in the House of Representatives is the next step in trying to get CMS to use its authority to pause Round 2021 of competitive bidding.

The letter, spearheaded by Reps. Cathy McMorris Rodgers, R-Wash., and Dave Loebsack, D-Iowa, asks CMS to pause the next round of the program for a year or through the duration of the public health emergency, whichever is longer.

“The political pressure of a letter like this makes a huge difference,” said Cara Bachenheimer, head of the government affairs practice at Brown & Fortunato. “Ultimately, CMS is accountable to Congress.”

The industry has a tight deadline for collecting signatures: July 29. The goal, though there is no “magic number,” is 80 to 100 signatures.

“Dear Colleague” letters have worked in the past to pressure CMS to, for example, stop applying bid pricing to accessories for complex power wheelchairs, and it could work again.

“We've had a lot of success with these,” said Jay Witter, senior vice president of public policy for AAHomecare. “This is a really big issue and we've used a lot of resources to convince CMS to make the change. The logical step is having them change it on their own.”

Best case scenario, the letter works; worst case scenario, it's an item that the industry's champions in the House can check off before taking the next step of introducing legislation.

“It says, 'We tried; we went to CMS; they have the authority; they could have delayed this,'” said John Gallagher, vice president of government relations for the VGM Group. “If I'm a member of Congress, this forces my hand.”

If there's something better than a best-case scenario, it's CMS announcing it will pause the program as part of its still-yet-to-be-published proposed 2021 payment rule for DMEPOS. The rule is typically published the first week of July.

“If I'm looking at this glass half full: We don't have a proposed rule yet, because they're in the midst of that decision-making process,” Bachenheimer said. “So the timing of the pressure (from the letter) and the rule not being out yet could not be more perfect.”