AAHomecare Calls for Public Comments on CMS Proposed Rule

The American Association for Homecare (AAHomecare) encouraged members of the HME industry to submit final comments on a proposed rule from the Centers for Medicare & Medicaid Services (CMS) impacting home health payments, competitive bidding and more before the deadline date on Friday, Aug. 29. 

“Allied industry groups, state & regional home medical equipment (HME) associations, patient and clinician organizations, and HME suppliers, manufacturers and distributors across the country are weighing in on the proposed rule and the return of an even-more-flawed version of the bidding program,” the AAHomecare said in its newsletter. “If you and your company aren’t planning on submitting comments, please take a moment and reconsider.”

The proposed rule would cut payment rates for home health agencies by 9% and reduce funding by over $1 billion. It also lays out several items related to the competitive bid program, including: 

• Potentially adding CMS and insulin pumps to the bid program
• Saying CMS has the authority to add some product categories to the bid program
• Adding “remote item delivery” to the CBP
• Changing bid rules and calculations
• Increasing the frequency of surveys and reaccreditations
• Allowing more authority to revoke supplier numbers
• Changing enrollment documentation requirements

“We understand that the scope of the proposed rule and the technicalities with some of the issues can feel daunting,” AAHomecare said. “But sharing comments doesn’t have to be complicated or exhaustive … You don’t have to comment on every issue; comments that cover just a few issues—or even one issue—are helpful and impactful. Look at the summary, pick out the ones that resonate with you the most—and tell CMS how they will impact your business and your patients.”

Several thousand comments have already been submitted in opposition to the rule ranging from providers describing how the rule will impact their business to patients explaining how the rule will affect their health. One person described how the rule will impact their health due to not being able to get a prescribed ostomy bag.

“I have genuinely feared in the past that if insurance did not cover my bag needs, I would end up with a painful and possibly lethal skin infection,” the comment reads. “Ostomy bags are not medical devices, they are prosthetics that are carefully prescribed and selected for each patient by their medical providers. Redefining ostomy supplies and including them in competitive bidding could mean debilitating skin wounds, plummeting quality of life (which could prevent ostomates from work and school), and even death. Please do not limit people’s access to these vital and lifesaving devices.” 

“I am an ostomy and continence nurse,” another person wrote. “I see firsthand the unnecessary complications that can arise when my patients doesn’t have what they need. Competitive bidding sounds like a good idea on the surface but will restrict access to what each specific patient needs. Please do not support this. Having the right supplies is crucial for health and quality of life.”

AAHomecare is one of many organizations speaking out against the proposed rule. The National Alliance for Care at Home (the Alliance) also criticized the rule and encouraged providers to weigh in.

“The sustainable delivery of home health care nationwide hinges on this critical rule,” said Steve Landers, CEO for the Alliance. “CMS has failed not just our providers, but the millions of Americans who depend on home health services—whether they are recovering after a hospital stay or managing chronic conditions in the place they are most comfortable—at home. We are alarmed by the negligent proposed payment update, which deepens a heartless pattern of insufficient adjustments that have already led providers to close their doors and reduce services, and now threatens to further diminish care access by compelling more home health agencies to take similar actions. While we stand with CMS in its efforts to improve the quality of care and program integrity while saving the system money, this flawed and shortsighted payment update will actually increase costs to the American health care system.”

AAHomecare added that those who feel the CMS rule doesn’t apply to them should also share their comments. 

“These rates will impact all Medicare rates for products included in the program—even in rural areas that receive the 50/50 blended rate,” the organization said. “And the rates from the bidding round will also guide Medicaid rates in 32 states, set rates for TRICARE and influence Medicare Advantage plans and private insurance payers that use the Medicare rates to help inform their rate-setting. Proposed annual reaccreditation requirements will be a burden for all Medicare providers, as well.” 

For more information, visit the AAHomecare Proposed Rule Commenting Resources page.