Stakeholders seek rate freeze, delay

WASHINGTON - With only the first of two planned cuts in effect, industry stakeholders say a freeze of current rates in regional and rural areas is their best bet.

“It's hard to put the genie back in the bottle,” said Tom Ryan, AAHomecare president and CEO. “The cuts are here so our champions believe that this is our best alternative.”

On Jan. 1, Medicare began paying for HME in regional and rural areas based on a 50/50 blend of the previous fee schedule amounts and the bidding amounts. On July 1, rates in those areas will be based only on the bidding amounts.

At the same time as they advocate for a freeze, stakeholders and lawmakers are putting pressure on CMS to delay that full rate cut, with Sen. John Thune, R-S.D., asking CMS Acting Administrator Andy Slavitt at a Jan. 21 Senate Finance Committee hearing whether six months is enough time to monitor the impact of the changes.

“CMS needs to be able to show Congress what is it they are doing to monitor, in real time, basis access issues, quality of care, and the impact to small business,” said John Gallagher, vice president of government relations for The VGM Group. “They are not able to prove that, so there's a lot of pushback to say, 'OK, you need to back off on this.'”

A study from the Office of Inspector (OIG) on the impact of bidding in rural areas also should have been completed before CMS barreled ahead, say stakeholders.

In the meantime, providers must make do with the hand they have been dealt. While so far they aren't reporting many issues, it's only a matter of time, stakeholders say.

“For most providers, their accounts receivable hasn't caught up with it yet, so they are not feeling that pinch,” said Gallagher. “But they will.”

Previously, stakeholders were focusing their attention on bills in the Senate and House of Representatives that included a longer phase-in period for the reduced reimbursement and a 30% increase to reimbursement in rural areas and a 20% increase in regional areas.