Take these opportunities to advance industry priorities
by Seth Johnson

Late last year Congress developed legislation to permanently fix the flawed Sustainable Growth Rate (SGR) physician payment formula, which historically results in reductions to physician payments that Congress then acts to overturn. The good news is that as this legislation to permanently fix the problem started working its way through the legislative process in December, two industry priorities were on the table for inclusion in the bill. One would provide limited relief on competitive bidding and the other would include the separate benefit for complex rehab technology legislation in the larger bill. In the end, a very limited competitive bidding amendment was included in the Senate bill. The House did not include any amendments. Congress is working now to reconcile the differences of the Senate and House bills by a March 31 deadline to avoid a 24 percent cut in physician payments. This provides the industry an opportunity to work to secure these priorities in the final package. This is the best opportunity yet to secure relief on competitive bidding and advance the separate benefit for complex rehab technology. Are you ready to help advance these priorities? Here’s what you need to know. While an amendment to provide some relief from the flawed structure of the Medicare bidding program was included in the Senate Finance Committee markup, the end product was significantly watered down to only require that CMS verify that bidders meet any and all state licensure requirements at the time of bidding. This is good, in that the Finance Committee has taken formal action on this issue and recognizes the need to fix the program. Efforts are currently underway with the key committees in the House and Senate to strengthen the bidding language as the SGR legislation continues to work its way through the process toward votes in both chambers in March. The industry is looking to include both short term relief for providers currently impacted by Round 1 or Round 2 of the bidding program and longer term structural reforms, such as making the bids binding and utilizing the clearing price to establish payment amounts. These are the provisions that have the most support according to our champions in Congress. The good news is the Senate Finance Committee bill includes a bidding amendment that can be added to. Now is the time to make the case to our individual legislators that competitive bidding reform be a priority in this legislation. While neither the House nor Senate bills currently include the HR 942/S.948 Complex Rehab Technology (CRT) Separate Benefit legislation, Senator Schumer (D-NY) had an amendment drafted to include during the Finance Committee markup in December. The amendment was ultimately 1 of the 120 or so other amendments not offered at that point in the process at the request of committee leaders. The good news is the amendment has been drafted and is ready to go. Now more than ever, the industry is positioned to advance this priority to CRT providers. We need to focus on increasing the level of awareness and support for the largely bipartisan legislation in the Senate to help increase the likelihood that the amendment will ultimately be included in the larger SGR bill. Working with our consumer and clinician group partners will be a key to success in this effort. We, as an industry, must focus on making sure our legislators are educated and understand why these issues must be included in this bill and support our efforts toward that end. Providing local examples to them will help them see the need to advance these priorities for their constituents and helping them understand the negative implications and outcomes if they are not included. 2014 is an election year, so many House and Senate members should be more active and engaged in order to give their constituents reason to vote for them in November. Now is a critical time to contact your legislators to let them know this is a priority to you, your company and many of their constituents. Dial (202) 224-3121 and let your voice be heard.