The political landscape in early 2014

We may have closed the book on 2013, but as The VGM Group's John Gallagher reminded me this week, we didn't close the book on replacing the competitive bidding program with a market-pricing program (MPP) program.

In the House of Representatives, H.R. 1717 still has a pulse with 164 co-sponsors in the 113th Congress.

In the Senate, an amendment requiring providers to prove they meet licensure requirements in states where they don't have a presence before they submit bids, is tucked into a recently passed “doc fix” bill.

What happens from here could be interesting, predicts Gallagher, vice president of government relations. And by interesting, he means good, bad or both.

Here's why: The “doc fix” bill that was passed is a short-term patch and lawmakers have until March 15 to come up with a more long-term fix to prevent reimbursement cuts to physicians. That, or pass another short-term patch, which is always a possibility, but the administration and others are pushing really hard for a long-term fix, Gallagher says.

On one side, this gives industry stakeholders time to try and bulk up the amendment in the “doc fix” bill to include more substantive changes to competitive bidding, like requiring CMS to award contracts to providers within 50 miles of the competitive bidding area, he says.

“What's in there is a placeholder more than anything,” Gallagher said.

On the other side, a long-term fix will likely be costly and stakeholders will want to make sure cuts to HME aren't used as a pay-for.

A lot of how the next few months play out will be affected by the White House's nomination of Sen. Max Baucus, D-Mont., as the next U.S. ambassador to China. Baucus is chairman of the influential Finance Committee, and neither Baucus nor the staffers of the committee have been friends of the HME industry, Gallagher says.
When Baucus leaves his post, who will replace him (Sen. Ron Wyden, D-Ore., is a likely candidate, Gallagher says) and how much of the committee's staff will change (some staffers have already jumped ship, but some will surely stay, he says).

“Right now, we're watching closely to see how this transpires,” Gallagher said.

 Stay tuned.