The legislation sets the stage for possible future regulatory relief for rural providers, as it requires HHS to reissue payment regulations for items and services furnished on or after January 1, 2019, with adjustments to the non-bid fee schedule in some areas based on stakeholder input, costs, volumes, and numbers of suppliers serving those areas.
Specifically, the legislation will provide six months’ worth of retroactive relief for the second phase of bidding-derived cuts for rural and non-bid area providers; delays the application of bidding-derived pricing reductions for complex rehab technology accessories used with Group 3 power wheelchairs for an additional six months; accelerates the application of plans to limit state Medicaid reimbursement amounts for HME to the Medicare fee-for-service payment rates, including applicable competitive bidding rates, by one year, to Jan. 1, 2018; and also instructs HHS to conduct a study on the impact of the bidding program on the overall number of HME providers and availability of HME products over the course of 2016.
While AAHomecare and other HME stakeholders advocated for a longer delay for the second phase of bidding derived cuts, this legislation marks an important step in efforts to scale back the effects of the bidding program. Both chambers of Congress, along with party and committee leadership, have recognized that the home medical equipment community in rural areas needs relief and that the bidding program requires more scrutiny.
These measures set the stage for working with the new Administration to move towards more sustainable Medicare reimbursement policies for all HME providers, as well as again taking up these issues in the 115th Congress.
Also this week, President-elect Donald Trump announced he will appoint Congressman Tom Price (R-Ga.) to serve as Secretary of Health and Human Services in his Administration. Price, who has represented Georgia’s 6th Congressional District since 2004, has been a consistent advocate for better public policy in the healthcare arena and has championed legislation to make sure that patients who rely on home medical equipment have access to those products and related services.
Seema Verma, founder and president of health policy consulting firm SVC Inc., was selected to serve as Administrator of the Centers for Medicare and Medicaid Services.