Industry readies to press forward on relief

WASHINGTON - With PAYGO-related Medicare cuts behind them, industry stakeholders are re-focusing on the DMEPOS final rule, lining up a new champion in Congress to lead reimbursement relief efforts. 

On Thursday, the Senate approved legislation to prevent across-the-board, 4% PAYGO-related cuts to Medicare reimbursement from taking effect in 2022. 

“It’s a large victory that resulted from a consortium of efforts from across the health care sector,” said Tom Ryan, president and CEO of AAHomecare. “Now, we are anxiously awaiting the final rule in the next week or two – there’s been a lot of gentle pressure there (to get it released).” 

The rule, sent to the Office of Management and Budget in mid-October, would continue the 50/50 blended rates for rural areas and adjust payment amounts in non-competitive bidding areas. 

Stakeholders have their fingers crossed, however, that the rule will also address making permanent the 75/25 rate for non-rural, non-bid areas that was established last year and is set to expire when the public health emergency ends.  

“With all the comments and pressure that they’ve heard around supply chain issues, surcharges and increased costs, we’re hoping they listen to us in the final rule and give us the 75/25 (rates),” Ryan said. 

That, in turn, will inform the industry’s next steps, which could include pushing forward with legislation to address relief. With industry champion Rep. Cathy McMorris Rodgers, R.-Wash., now the ranking member of the House Energy & Commerce Committee stepping back as the lead of those efforts, stakeholders say they are also working with Rep. Markwayne Mullin, R.-Okla., to step up. 

“He’s a longtime champion for the industry and he’s a real fighter for issues that are close to his heart,” said Jay Witter, senior vice president of public policy for AAHomecare. “We’ve met with his top staff and he’s excited to spearhead this from the Republican side.” 

Stakeholders have also been in talks with Rep. Paul Tonko, D.-N.Y., and on the Senate side with Sen. John Thune, R.-S.D., a long-time supporter of relief efforts. 

“We’ve had numerous discussions with his staff about what happens after the PHE ends,” Witter said. “The Senator hasn't committed to any specific strategy or legislation yet. He is evaluating options and strategies for relief in non-competitive bidding areas."