ATLANTA (September 6, 2018)—On January 1, 2019, any willing provider will be able to participate in the Medicare program, regardless of prior bidding “wins” or losses. What should providers do? Educational advisory board (EAB) members at Medtrade will outline all of the options, possible action, and consequences in a new educational track dubbed “The New Competitive Bidding.”
competitive bidding
WASHINGTON, D.C. (August 29, 2018)—On August 24, the Government Accountability Office (GAO) released a report on the effects of reimbursement cuts in non-bid areas in the year following their implementation in January 2016.
WASHINGTON, D.C.
WATERLOO, Iowa (August 15, 2018)—VGM Group has released a new tool for suppliers to use as they assess where CMS has deemed rural, non-rural and competitive bidding areas to be. The interactive maps include all 50 states and allow providers to determine which category a ZIP code falls under.
WASHINGTON, D.C. (July 26, 2018)—This week, West Virginia’s Congressional delegation released a letter to CMS Administrator Seema Verma asking her to address their concerns regarding “the significant cost differences that rural providers face relative to their urban counterparts within the CBAs,” after those issues were not resolved in the DME-related interim final rule released in May.
WASHINGTON, D.C. (July 12, 2018)—AAHomecare has developed a new two-page summary that recaps 16 significant reimbursement policy shifts affecting the HME community, including fee schedule adjustments, the implementation of competitive bidding, expansion of bidding-derived prices nationwide, and limiting the federal allowable for Medicaid.
Opportunities for improvement exist
WASHINGTON, D.C. (June 18, 2018)—The June 15 release of MedPAC’s report to Congress on Medicare and the health care delivery system represents another missed opportunity by the Commission to address the serious problems with Medicare’s competitive bidding program for durable medical equipment (DME) as well as the disastrous application of bidding-derived pricing to rural and other less-populous communities, stated the American Association for Homecare (AAHomecare).
Report does not adequately assess beneficiary access issues, CQRC says.
WASHINGTON, D.C. (May 29, 2018)—The Council on Quality Respiratory Care (CQRC) today warned a report released by the Department of Health and Human Services Office of Inspector General (OIG)—Round 2 Competitive Bidding for Oxygen: Continued Access For Vast Majority of Beneficiaries—underestimates the negative impact the Competitive Bidding Program for Durable Medicare Equipment (DME) continues to have on beneficiary access to home respiratory supplies and services.
Budget and MedPAC recommend expansion, in spite of CMS evaluations.
WASHINGTON, D.C. (May 3, 2018)—United Spinal Association, United Ostomy Associations of America and Spina Bifida Association partnered with AAHomecare on a comprehensive white paper to articulate why competitive bidding should not include urologicals and ostomy supplies. The white paper counters recent references to expanding the controversial bid program in the President’s Budget and MedPAC recommendations.
Home respiratory therapy patients have lost access to service under savings program.
WASHINGTON, D.C. (March 22, 2018)—The Council for Quality Respiratory Care (CQRC) today released a new report that highlights the urgent need for policymakers to reform Medicare’s outdated payment methodology. The report outlines how the current payment system, called the competitive bidding program (CBP), restricts patients’ access to the oxygen and medical equipment they need, despite the Centers for Medicare & Medicaid Services’ (CMS) best intentions.
AAHomecare releases spreadsheet of supporters of current legislative efforts.
Via AAHomecare, WASHINGTON, D.C. (February 22, 2018)—Champions on Capitol Hill remain highly engaged in efforts to roll back bidding-derived Medicare reimbursement cuts in rural/non-bid areas and to address the “double dip” cuts for oxygen in rural areas. With potential omnibus spending legislation expected in late March as a possible vehicle for language from H.R. 4229, it’s critical that we continue to engage Capitol Hill to support these priorities—especially over the next three weeks.
Concerns over cuts and bid limits exist for rural providers.
Via AAHomecare, WASHINGTON, D.C. (February 14, 2018)—The recently released FY 2019 budget proposal from the White House includes several items related to DME. AAHomecare has especially strong concerns about the first item noted below and plans to talk to the Administration for clarification.
Provisions found in the budget proposal and an HHS summary document include:
AAHomecare and the American Thoracic Society will brief staff on issues affecting patients.
Via AAHomecare, WASHINGTON, D.C. (February 7, 2018)—Rep. Cathy McMorris Rodgers (R-Wash.) has scheduled a congressional staff briefing to discuss AAHomecare’s study on the effects of the bidding program on HME patients, discharge planners and suppliers, as well as a study published by the American Thoracic Society (ATS) highlighting access problems for oxygen patients.
Submit your ideas now.
ATLANTA (January 18, 2018)—Medtrade organizers are looking for experts with a willingness to share their successes and struggles. Consultants and providers with the kind of experience that can help others are invited to apply to speak at Medtrade 2018, scheduled for Oct 15–17, 2018, at the Georgia World Congress Center in Atlanta.
Providers can feel alone in their business journey
AAHomecare team provides resource for insurance providers, congressional advocacy.
WASHINGTON, D.C. (November 8, 2017)—AAHomecare’s Complex Rehab and Mobility Council (CRMC) has developed a new white paper that clearly explains the differences between complex rehab technology (CRT) and standard mobility products.
The legislation also addresses oxygen double dipping.
WASHINGTON, D.C. (October 12, 2017)—Rep. Cathy McMorris Rodgers (R-Wash.) has been working on legislation to provide relief for non-CB areas and address the “double-dip” cuts on oxygen; you can see a draft of the legislation here.
CMS updates guidance for providers, and RACs halt audits in storm affected areas.
—Via AAHomecare, WASHINGTON, D.C.
The bill would protect manual accessories from bidding-derived pricing and has strong bipartisan support.
WASHINGTON, D.C. (September 12, 2017)—Representatives Lee Zeldin (R-N.Y.) and John Larson (D-Conn) introduced legislation on Monday to exempt accessories for manual CRT wheelchairs from bidding-derived pricing with a strong, bipartisan roster of 42 original co-sponsors (23 Democrats, 19 Republicans). HR 3730 would complement earlier CMS action exempting accessories for group 3 power wheelchairs from bidding-derived pricing.
AAHomecare works with CMS on disaster related policy.
—Via AAHomecare, WASHINGTON, D.C. (August 7, 2017)—CMS and AAHomcare are both dedicated to instituting policies that protect beneficiary and supplier communities that have been affected by Hurricane Harvey. Last week, AAHomecare and several members of the Regulatory Council met with CMS regarding emergency and disaster related policies and procedures.