WASHINGTON, D.C. (May 13, 2016)—The Council for Quality Respiratory Care (CQRC)—a coalition of the nation’s home oxygen therapy providers and manufacturing companies who together provide in-home patient services and respiratory equipment to the majority of Medicare’s one million beneficiaries who rely upon home oxygen therapy—commended Representatives Tom Price (R-GA), Dave Loebsack (D-IA), Cathy McMorris-Rodgers (R-WA) and Peter Welch (D-VT) for introducing the Patient Access to Durable Medical Equipment Act (PADME), legislation that will protect patient access to respiratory care therapies by extending the implementation of severe Medicare cuts to durable medical equipment (DME).
“We strongly support the introduction of this legislation in the U.S. House and look forward to working with Congressman Price and his bipartisan colleagues to see this bill signed into law before July 1 to protect access to respiratory care for the vulnerable, elderly patients our members serve,” said Dan Starck, Chairman of CQRC. “This bill provides policy-makers with the time they need to assess the impact of the cut on the care being provided to patients and evaluate whether the additional cut should also be applied.”
In addition to supplying equipment, oxygen and supplies, home respiratory therapy providers provide patient-centered services to reduce hospitalizations. Working with hospitals and commercial payers, CQRC companies have developed and implemented programs to help reduce hospitalizations and Medicare program expenditures. Managed care programs and commercial payers already recognize the important role home respiratory therapy plays in reducing overall health care spending.
Despite the critical role home respiratory therapy providers play in managing COPD and reducing preventable hospitalizations and readmissions, providers received the first set of dramatic cuts to Medicare-reimbursed respiratory therapy on January 1. These cuts were the result of the Centers for Medicare & Medicaid Services (CMS) applying the competitive bid rates used in urban areas to rural and other non-competitive bid areas that Congress specifically excluded from the DME competitive bidding program. The CQRC is deeply concerned that these cuts puts senior access to high-quality and innovative home respiratory care at extreme risk. Further, CMS provided an accelerated six-month phase-in for the cuts, leaving little time for the Agency to assess the impact of the initial cut before implementing the second half of it.
The legislation provides relief to home respiratory therapy providers in non-competitively bid areas by allowing additional time for the implementation of the rate cuts. Specifically, the bill would:
- Extend the current phase-in of the blended rate (50 percent of the previous fee schedule rate and 50 percent of the new competitively bid-based rate) until October 1, 2017, which delays additional cuts in rural areas by 15 months.
- Adjust the bid ceiling on competitive bidding by setting ceiling at the FY2015 fee schedule rate and adjust for inflation to create a measure of stability in the competitive bidding program.
- Require publication of a monthly report by CMS to monitor the impact of the cuts on Medicare beneficiary access.
- Require CMS to take into account specific factors when adjusting the noncompetitive bid rates to ensure that the rates take into account unique aspects of providing services in rural and other nonurban areas.
More than one million Medicare beneficiaries rely upon home respiratory therapies to treat Chronic Obstructive Pulmonary Disease (COPD) and Obstructive Sleep Apnea. Home oxygen and sleep therapies allow patients to live independently, remain at home with their families and maintain quality of life.
Visit cqrc.org for more information.