Reimbursement relief: Stakeholders play all angles

WASHINGTON – Industry stakeholders say Congress is “definitely getting back to work,” after a long spring, during which there was little movement on HME issues. 

Stakeholders have been meeting with industry champion Rep. Cathy McMorris Rodgers, R-Wash., to discuss legislative language for competitive bidding relief, line up a co-sponsor and identify possible vehicles for the fall, they said. 

“We’ve had Hill visits, face-to-face meetings with members and talked about our issues and gotten some good response,” said Jay Witter, senior vice president of public policy for AAHomecare. “Members understand the challenges with increased costs.” 

One area where there has been movement this spring: CMS announced on June 23 that it would extend an 18-month pause on applying bid pricing to accessories for complex rehab manual wheelchairs for an additional 90 days, until Oct. 1.  

The extension shows that CMS does have the authority to make adjustments, something the agency has frequently said only Congress can do. So, while stakeholders continue to pursue legislative relief, this latest development may bode well for regulatory relief. 

“We want to convene with (CMS Administrator Chiquita Brooks-LaSure and her staff) to adjust single payment amounts,” said Tom Ryan, president and CEO of AAHomecare. “The rates are from six years ago and everyone is seeing price increases – raw material, freight costs – there’s no way to (sustain the rates).” 

One way CMS could provide regulatory relief: Release a final rule that would make permanent a 50-50 blended reimbursement rate in rural areas, stakeholders say.  

“Hopefully, they don’t back off,” Ryan said. “The question is, can we get enough pressure on the agency to release the rule? Hopefully, in a meeting with Brooks-LaSure, we can get those points across.”