Post IFR, stakeholders cast wider net for support

WASHINGTON - A major goal of the AAHomecare Washington Legislative Conference last week was determining whether or not Sen. John Thune, R-S.D., will continue to lead the HME industry's bid relief efforts.

With a bill in the House of Representatives, but no bill in the Senate, the big question is: Is Thune satisfied with the relief outlined in the recently released interim final rule, which impacts rural states like the senator's the most, or does he want to continue pushing for more widespread relief?

“Everyone's looking at Thune,” said Jay Witter, senior vice president of public policy for AAHomecare. “If (he's satisfied), we have other senators raring to go, but no one wants to move unless it's blessed by Thune.”

Per the IFR, CMS will revert to the 50/50 blended reimbursement rates in rural areas from June 1, 2018, through Dec. 31, 2018. It will not revert to those rates in all non-bid areas.

Thune, who sits on the Finance Committee, has been key to the industry's efforts in the Senate to date. He has introduced a bid relief bill in the past and, more recently, championed a provision, along with Sen. Heidi Heitkamp, D-N.D., in the 21^st Century Cures Act that requires CMS to take into consideration provider costs and other factors when setting reimbursement in non-bid areas for future rounds of the program.

“We need to clear Thune,” said Tom Ryan, president and CEO of AAHomecare.

In the House, H.R. 4229, which would provide relief in all non-bid areas and retroactively from Jan. 1, 2017, to Jan. 1, 2019, has support from 145 lawmakers, including more than a dozen on the Ways and Means Committee. Discussions there are transitioning to how to move the bill through the committee process.

“We don't need to introduce a new bill (in the wake of the IFR),” Witter said. “When the committee takes it up, they can mark it up and make modifications. If your member of Congress asks if the bill is still viable, it is.”

For CMS, AAHomecare has re-upped its retainer with law firm Foley Hoag, which has helped the association get meetings with high-level officials at the agency, as well as HHS, including Deputy Secretary Eric Hargan.

“When (former HHS Secretary Tom Price left), things came to a grinding halt, but we continued to pound away at it and with the energy and grassroots we generated, we've gotten access like never before,” Ryan said.