Lack of reimbursement relief starts to set in

WASHINGTON – With Medicare reimbursement decreases in non-rural areas now in effect, including 32% for oxygen and 37% for manual wheelchairs, HME providers are faced with making potentially difficult business decisions if relief doesn’t come their way soon, say industry stakeholders. 

Congress in January passed a stripped down, short-term government funding measure without including any significant health care extenders, including a provision to extend a 75/25 blended rate in non-rural areas, and stakeholders are now looking to a March 1 deadline. 

“I’m not hearing of any issues with access just yet, but these cuts could lead some providers to re-examine their product and patient mix,” said Tom Ryan, president and CEO of AAHomecare. “They need to make business decisions. The reality is the industry wants to continue to serve their patients and their referral sources.  Providers are going to hold off on operational changes if they think relief might be coming their way soon, but that won’t go on indefinitely.” 

The 75/25 blended rate in non-rural areas expired Dec. 31, 2023. 

The good news: The industry is as well-positioned as it has ever been to see the provision passed into law, says Jay Witter, who met recently with the staff of Rep. Steve Scalise, R-La., House Majority Leader. 

“We need to continue to talk to rank-and-file members of Congress and make sure they are aware of the cuts and that they go to leadership to indicate their concerns and cite the need for a quick resolution,” said Witter, senior vice president of government relations for AAHomecare. “We continue to do that, and we talk to the committees of jurisdiction on a daily basis. We just need to continue to put the pressure on.” 

It’s unfortunate, stakeholders say, that the industry’s relief measures have been caught in the crosshairs of larger political issues that have resulted in long-term government funding being continually kicked down the road. 

“Some of the partisan problems that are going on has caused many bills to not be signed into law,” Ryan said. “If this was a normal Congress, this would have been put to bed before the holidays.”