WASHINGTON, D.C. (April 20, 2016)—Leaders of the Senate Finance Committee have asked the U.S. Department of Health & Human Services (HHS) to delay the next round of bidding-derived reimbursement cuts for rural and non-bid areas for an additional twelve months and to disclose specific indicators the agency is using to monitor possible beneficiary access issues under the Medicare bidding program for home medical equipment.

In a letter to HHS Secretary Sylvia Burwell, Finance Committee Chairman Orrin Hatch (R-Utah) and Sen. Ron Wyden (D-Ore.), the ranking Democrat on the Committee, share their rationale for the request:

Specifically, we are concerned that the current six-month period does not allow sufficient time to detect and correct problems and, as a result, puts beneficiaries at risk of experiencing a delay in the receipt of needed DMEPOS or being unable to obtain items altogether. It is unlikely that CMS will be able to monitor, analyze, and make any necessary changes prior to July 1, 2016. The ability of the real-time claims monitoring that CMS uses for items provided in competitive bidding areas to assess the short-term impact of the DMEPOS fee schedule rate reduction in non­competitive bidding areas is questionable.

In addition to calling for more transparency in CMS’s monitoring efforts, the Senators suggest that the Agency monitor changes in the percentage of suppliers accepting Medicare assignment following the January 1 advent of bidding-derived rates, and also provide information on Medicare beneficiary complaints in the non-bid areas since that date.

The full text of the letter is available here.

AAHomecare applauds these Senators for their efforts to make sure the effects of significant initial reimbursement reductions for rural and non-bid area suppliers are well-understood and shared widely before additional cuts slated for July 1 take place.

The Senators’ concerns also make a strong case for quick action on the Patient Access to Durable Medical Equipment Act of 2016 (S. 2736), recently introduced legislation that would:

  • Delay the second cut for HME items in non-bid areas by 15 months, pushing back the second cut from July 1, 2016 until at least October 1, 2017.
  • Replace the bid ceiling for future rounds of bidding with the unadjusted fee service rates from January 1, 2015 instead of CMS’s current plans to limit future bid ceilings to the previous bid rates.
  • Require CMS to monitor and report on access issues and health outcomes for Medicare beneficiaries utilizing HME, with updates provided on the CMS website on a monthly basis.

If your Senators are not currently listed among current co-sponsors for S. 2736, please share this letter with healthcare staffers in those offices as part of your contacts asking for support of this legislation; you can also encourage your Representative to contact Congressman Tom Price’s office to sign on as an original co-sponsor for companion House legislation expected soon.

Visit aahomecare.org for more information.