It is time to press the reset button.
by Tom Ryan

The American Association for Homecare acts as the industry liaison to multiple regulatory agencies, including the Center for Medicare and Medicaid Services (CMS). We help navigate regulatory challenges by:

  • clarifying emerging issues so that members can plan accordingly or course correct
  • tracking rules through their lifecycle from proposal to implementation
  • making clear the industry’s position and negotiating on its behalf
  • influencing regulatory agencies formally and informally
  • advocating for responsible changes and solutions
  • exposing the unintended consequences of regulatory nuances
  • giving visibility to how different rules might interact in a negative way
  • tying together the big picture of regulations that affect multiple products
  • sharing the real-world impacts of ill-conceived regulation

AAHomecare and CMS have met 11 times thus far in 2014 and made progress in certain areas. At a meeting in late May, both staffs agreed that face-to-face exams and WOPDs can be completed by different physicians and ZPICs and RACs should be included in the enforcement delay. The things that divide AAHomecare and CMS are small compared to our shared mission. We’re all at the table to help Americans access quality, affordable health care. We are both frustrated that congressional politics and limits on regulatory authority prevent practical solutions to the challenges facing patients. This is why we need to press the reset
button on how AAHomecare and CMS work together. We can help each other improve our positions, rise above the quagmire and succeed in priority areas. As a nonprofit national trade association, AAHomecare is taking a strategic, long-term view on how we work with our regulatory colleagues. Acting as a trusted resource, AAHomecare is plugged in with CMS at the executive and staff levels to make sure they have the information, analysis and perspective of the industry when they are making rules. The rulemaking process is intended to be collaborative, which is why it is crucial for agency leaders and staff to engage stakeholders early in the regulatory rulemaking process. Working together benefits AAHomecare and CMS in four ways. First, as the saying goes, two heads are better than one. Engaging stakeholders such as AAHomecare results in better policy because we bring our collective expertise to the table. AAHomecare offers the benefits of deep technical knowledge, frontline experience, business acumen and nonprofit credibility together with a focus on serving patients. Second, no one has all the answers and everyone has blind spots. We all benefit when the best and the brightest work together to tackle the tough issues. And while everyone has different 
motivations—whether you are a consumer group, nongovernmental organization, member, company or another trade association—we all bring a different and valid perspective that should be taken into account when an agency creates rules. This helps avoid tunnel vision. The Governmental Accountability Office (GAO) agrees. The GAO reports that when all parties potentially affected participate in the rulemaking process, it leads to higher quality rules and fairer treatment of the persons affected. Third, being collaborative bolsters 
credibility. It is hard to bring credibility to your side of the argument if you are not willing to listen to other ideas. In fact, experts on administrative law have noted that when agencies listen and respond to comments, they increase their credibility and accountability. Fourth, collaborating prevents challenges down the road. Business or government, no one is immune from letting the past inform the present. Working together throughout the rulemaking process can help break through outdated ideas on both sides. When different viewpoints are taken into account, groups are less likely to challenge the decision later and more likely to help with a smooth implementation process. We have pressed the reset button. We are acting as a trusted resource. We are ready to work collaboratively. We are halfway through 2014 and now is the time for AAHomecare and CMS to make real progress together.