Rural Rollout and Audits Dominate Discussion at AAHomecare Update

ATLANTA (October 27, 2015)—If CMS has its way, rural providers will face a reimbursement reduction of up to 45% on January 1, 2016. The so-called “rural rollout” of competitive bidding is a major concern for Tom Ryan, president and CEO of AAHomecare, but it’s one of many.

“The battles out there are outrageous, and they just keep coming,” said Ryan during the morning AAHomecare Update on Oct 27, day two of Medtrade. “Audits? Outrageous. Expansion of competitive bidding? That’s not sustainable. It’s not going to work…We’ve got legislation that we hope will fix it.”

With Rep Tom Price (R-Ga) as a staunch ally and industry champion, Ryan and Jay Witter, AAHomecare’s senior VP, Public Policy, say that anticipated legislation would require CMS to:

• Establish a 30 percent adjustment to address increased costs suppliers incur in non-competitive bidding areas to be applied to average regional single payment amount as determined by the methodology set forth in 42 C.F.R. 414.210(g) (79 Fed. Reg. 66120 (November 6, 2014)), as well as an update mechanism;
• Provide for a four-year phase-in of the national price adjustments to the DMEPOS fee schedule set forth in 42 C.F.R. 414.210(g) (79 Fed. Reg. 66120 (November 6, 2014)) when implementing them; and
• Establish in statute the bid limit ceiling for competitive bid contracts that begin on or after January 1, 2017 at the unadjusted fee schedule payment rates as of January 1, 2015.

These provisions would serve as a starting point as the association moves forward in negotiations with leaders in Congress to have the language either included in future legislation, or as a stand-alone piece.

Audits continue to plague providers, and AAHomecare officials are collecting data to show lawmakers the full effects. Ryan and Witter urged all providers to go to www.hmeauditkey.org and input their information.

“We have people willing to fight for us,” said Ryan, “but we need that information.” 

Visit aahomecare.org for more information.

—Greg Thompson