Stakeholders apply steady pressure for bid relief

WASHINGTON - Industry stakeholders say they're primed to build further support for bid relief after a post-July 4^th recess surge resulted in a total of 49 signatures for a Senate sign-on letter.

The letter, spearheaded by Sens. John Thune, R-S.D., and Heidi Heitkamp, D-N.D., asks HHS Secretary Tom Price to use his regulatory authority to provide bid relief in rural areas. A similar letter in the House secured 154 signatures in June and helped to preserve reimbursement for accessories for complex power wheelchairs.

“It makes it easier for the administration to make those improvements when they know there's significant support for doing it,” said Cara Bachenheimer, senior vice president of government relations for Invacare.

There's significant urgency to get something done. A recent review of the Medicare Supplier Directory by AAHomecare showed the number of traditional DME suppliers is steadily decreasing, with roughly 6,086 unique suppliers and 9,810 locations nationally as of July of this year—a decrease of 42% since 2013.

“Every month that goes by, we are losing critical mass,” said Tom Ryan, president and CEO of AAHomecare. “For every business that closes, there is going to be a patient access issue.”

Case in point: The recent decision by LifeCare Solutions to pull out of California means 30,000 patients need to find new providers. But CMS doesn't get it, say stakeholders.

“CMS uses their metric of participation rate, which doesn't change,” said Ryan. “We don't think that does a deep enough dive to determine other costs to other parts of the healthcare system. They strictly look at DMEPOS and that's an issue.”

Still, stakeholders say they are encouraged by some positive signs. The agency recently released its proposed 2018 changes to the End-Stage Renal Disease Prospective Payment System, and it contained no DME-related provisions.

“There's speculation that there is work going on for a separate regulation that would make improvements to the bidding program,” said Bachenheimer. “I don't have any idea how quickly we will see either an interim final rule or a proposed rules or some other indication they are moving forward. It could be days, weeks or months.”

While stakeholders are currently pressing for a regulatory fix, they are prepared to go the legislative route if necessary, they say.

“We are growing short of time for the announcement of the next round of bidding,” said Jay Witter, senior vice president of public policy. “We continue to work with our champions and they are poised to do something legislatively whenever the time is right.”