Stakeholders: Get in front of lawmakers in August

PHOENIX – When Congress breaks for recess next month, the industry needs to prime the pump for the fall, said John Gallagher, vice president of government relations for VGM, at Medtrade West. 

“It’s time for the August of Action,” he said during a legislative update at that the show. “They’ll have the infrastructure package behind them, so when they come back, they will be dealing with issues related to Medicare and health care, so reach out to them while they are home.” 

Lawmakers should be receptive to the industry's message, Gallagher says, with HME providers never shining brighter than they are now due to the COVID-19 pandemic. 

“Coming out of the pandemic, you’ve got to be front and center,” he said. “Build a message with Congress. You have increased costs and inflation on top of coming out of the pandemic.” 

Not everyone in Washington, D.C., is likely to look favorably on the industry, however, particularly related to its efforts to get relief from the competitive bidding program. While stakeholders are pressing for a meeting with new CMS Administrator Chiquita Brooks-Lasure, they are more likely to get time with Principal Deputy Administrator Jonathan Blum. 

“His resume includes the competitive bidding program, (which he has touted as a success),” said Tom Ryan, president and CEO of AAHomecare, during the AAHomecare update at Medtrade West. “We’re hoping during the intervening period of time, there was recognition that the program failed.” 

When it comes to competitive bidding, stakeholders have more questions than answers at this point. Will they or won’t they in 2024? Will it just be for braces again? What changes, if any, will they make? And when? 

"To bid in 2024, they’d have to put a rule out this year, so we would expect to see it within the next 90 days or they won’t be able to do it in 2024,” said Kim Brummett, vice president of regulatory affairs for AAHomecare. “We need to be concerned that they could change a lot of the things we gained in this last round. The bid ceiling could go away; we could lose the lead item bidding; they could go with HCPCS by HCPCS bidding.” 

That brings stakeholders back to the importance of August. 

“Tell members what’s happening,” Ryan said. “Go on record. It brought the market to the lowest possible pricing. It created access issues. Forty percent of us went out of business. The program needs to be (over).”