AAHomecare Medicare Reimbursement Legislation Campaign Central
Advocating for sustainable Medicare reimbursement policy remains a priority for AAHomecare. Working with our champions on Capitol Hill, we have managed to secure substantial relief for HME suppliers in rural areas in the form of 50/50 bended rates until the next competitive bidding round, as well as a 75/25 blended rate for suppliers in non-rural, non-CB areas through the duration of the ongoing COVID-19 Public Health Emergency (PHE).
AAHomecare is actively working to support S. 1294, legislation extend the current 75/25 blended rate for non-rural, non-CB are suppliers though the end of 2024. We are also working with our champions in the House to introduce legislation that would establish a 90/10 blended rate (90% competitive bidding rates/10% unadjusted Medicare fee schedule rates. Learn more about these twin advocacy efforts below.
S. 1294 - Extending the 75/25 Blended Rate in Non-Rural, Non-CB Areas
On April 26, 2023, Sen. John Thune (R-S.D.) and Sen. Debbie Stabenow (D-Mich.) introduced S.1294, legislation to further extend the Medicare 75/25 blended rate for non-rural, non-CBA suppliers through the end of 2024. The legislation extends relief granted in the 2022 Omnibus budget legislation keeping 75/25 rates for an additional year and provides more stability for suppliers in these areas. The bill would also impact rates from other payers who are influenced by Medicare rates, including TRICARE and Medicaid programs in more than 20 states.
Help build additional support for this legislation by asking your Senators to co-sponsor this legislation – follow the steps below to send a concise, effective message to your Senator asking them to sign on.
The most important step you can take today: e-mailing your Senators' healthcare staffers asking them to co-sponsor S.1294 - Competitive Bidding Relief Act of 2023.
Step 1 – Who to contract.
If you don’t know the name and email address of the staffer who handles healthcare issues for your Senator, call their Capitol Hill office and ask for that information. Simply ask “I need the name and email address for the individual who handles healthcare issues for your office.” Almost every office will give you that information without question. You can find basic contact info for your Senator here. If your Senator is on the Finance Committee, their support is especially important.
Step 2 – Crafting Your Email
Keep it simple for maximum impact. Your most effective email will be short, clear and to the point. Here’s the points to make:
Who you are: Just a sentence or two about you and your company, where you are located, and the patients you serve.
Why you are writing: Just a sentence or two about how repeated cuts to Medicare reimbursement rates over have impacted your company and your ability to serve patients. Any details you can add about increased product or operational costs in recent years against static Medicare reimbursement rates for HME is helpful, but you don’t need to list them all.
What you are asking for: Senators John Thune and Debbie Stabenlow have just released S. 1294, legislation that extends a recent measure of relief granted to home medical equipment providers though a 75/25 blended rate of adjusted and non-adjusted Medicare rates. Please co-sponsor the legislation – contact Sen. Thune's or Sen. Stabenow's office to sign on. The legislative language can be seen here. You can also include a link to our updated Issue Brief with your email.
End by thanking them for their consideration, asking them to let you know if they will sign on as a co-sponsor, and urging them to contact you with any questions.
Step 3 - Optional details
Did you meet with your Senator as part of AAHomecare’s Leadership Fly-In on May 9-10? You can/should remind them that you met with their office to discuss the need to align Medicare reimbursement rates with the market/cost environment you face.
Step 4 - Follow Up for Maximum Impact
Please share any replies you get, positive or negative, with Gordon Barnes at gordonb@aahomecare.org. And, of course, respond appropriately to those replies.
If you do not get a reply within one week, consider calling and asking to speak with the staffer on the issue, or send a follow-up email.
House Legislation - 90/10 Rates for Former CBAs and 75/25 Rates in Non-Rural Areas
AAHomecare and other industry stakeholders are working with HME champions on the House side to build support for for legislation to apply 90/10 blended Medicare reimbursement rate for items in the 13 product categories whose bid results were not implemented in Round 2021 -- as well as for similar provisions to S. 1294. While there currently is no active legislation with this provision, we encourage suppliers who have a strong existing relationship with their House members to make this request:
Congress must address out-of-date DMEPOS Medicare payment rates. Please support forthcoming legislation that would apply 90/10 blended rates in former competitive bidding areas (CBAs) and extend the 75/25 blended rate for DME items for non-CBA relief until the end of 2024
Please contact us (see below) if you would like help setting up a meeting or call with your House member or help crafting an email to a healthcare staffer on this issue.
We're Here to Help!
The AAHomecare team is happy to help you craft your note, find the appropriate contact, respond to any feedback you get from the Hill, or answer any other questions on this issue. Please email Ashley Plauché (ashleyp@aahomecare.org) AND Gordon Barnes (gordonb@aahomecare.org) for quickest assistance.
Thank you for taking action! HME advocacy takes extra effort and commitment; we truly appreciate your contributions to this important campaign -- it makes a difference!