Respiratory Experts Applaud Passage of PADME Act in House

WASHINGTON, D.C. (July 6, 2016)—The Council for Quality Respiratory Care (CQRC)—a coalition of the nation’s home oxygen therapy providers and manufacturing companies—commended Congressman Tom Price (R-GA), David Loebsack (D-IA), Cathy McMorris-Rogers (R-WA), Peter Welch (D-VT) and their colleagues in the United States House of Representatives, for passing the Patient Access to Durable Medical Equipment (PADME) Act (H.R. 5210), legislation to delay the phase-in of deep Medicare cuts to home respiratory care supplies and services.

“We applaud the U.S. House of Representatives for passing this legislation, which will now delay cuts that took effect in July 1. This legislation is a positive step, but at least 12 months is needed to ensure adequate time to measure and monitor the impact of earlier cuts that took effect on January 1,” said Dan Starck, chairman of CQRC.

The Senate passed similar legislation last month, which would also extend the phase-in period, but for an additional 12 months beyond the 6-month phase-in CMS provided. “While we are pleased that both chambers have agreed an extension of the phase-in is necessary, we need policy-makers to come together on legislation to protect both patient access and quality of services. We continue to have significant concerns with the established competitive bid rates and their application to patients nationwide,” added Starck.

The CQRC’s concerns have been echoed by bipartisan lawmakers, patient groups, physicians and industry leaders alike, who have all expressed serious reservations with the application of competitive bid rates to other non-competitive bid areas that Congress specifically excluded from the DME competitive program, underscoring the importance of delaying the cuts.

COPD Foundation: “Over 1 million patients rely on supplemental oxygen to maintain active, healthy, and engaging lives. Countless studies have documented that the use of supplemental oxygen extends the life of its dependent patients as well as improving their quality of life, health outcomes and overall wellness. With the roll out of competitive bidding nationwide, oxygen access has become less certain for COPD patients. More portable and lighter, liquid oxygen is no longer available from many DME companies and choice and delivery options are being cut, leaving patients to scramble to keep up with the changes.”

National Association for Medical Direction of Respiratory Care: “We have serious concerns that further action by the Centers for Medicare and Medicaid Services (CMS) on competitive bidding will be detrimental to a range of pulmonary related patients, particularly those who rely on supplementary oxygen and certain ventilators for treatment of a range of pulmonary diseases.”

Health care stakeholders, including Advanced Medical Technology Association: “Durable medical equipment is vital to maintaining and improving the health and quality of life for millions of Medicare patients needing these products in their homes. Losing access to these crucial technologies, as well as access to high quality and physician prescribed products, due to severe cuts to DME payment rates will compromise patient health. We urge you to take up and pass legislation that will protect patient access to needed durable medical equipment.”

Home respiratory therapy supplies and services are vital to managing Chronic Obstructive Pulmonary Disease (COPD) and other pulmonary conditions. Data show home oxygen care reduces preventable hospitalizations and readmissions, signally that reduced access to quality respiratory care in the home will result in increased emergency room (ER) visits and readmissions, therefore harming patient outcomes and increasing Medicare costs.

The House bill provides temporary 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, which delays additional cuts in rural areas by 3 months.
• Requires HHS to conduct a DME study over the course of the three months to identify issues related to patient access.

With the full DME cuts having taken effect on July 1, the Congress must act now to ensure a bill extending the phase-in is signed into law,” said Starck.

Visit cqrc.org for more information.