Competitive Bidding

Medicare's unsustainable bidding program for home medical equipment hurts patients and providers.

AAHomecare has received confirmation that H.R. 5210, the Patient Access to Durable Medical Equipment Act, did not successfully clear through the Senate before adjournment.  This means that the July 1 round of cuts for rural and non-bid area suppliers will remain in effect unless Congress takes action when they return in September.  You can read quotes from AAHomecare's Tom Ryan in our alert on the subject here; information on AAHomecare's plans to move forward from that alert are noted below.

Moving Forward

We understand and appreciate that the July 1 cuts are going to cause significant pain and disruption for AAHomecare members operating in rural and non-bid areas.  Many of you may be forced to make difficult business and operational decisions in the coming weeks, and these cuts could make it challenging for some companies to keep their doors open.

AAHomecare’s leadership and staff remain steadfast in our commitment to fight on your behalf.  We have already been in contact with our champions on Capitol Hill and other HME stakeholders to determine the best path forward to roll back these cuts when Congress returns.

We believe that the Senate and House bills passed in recent weeks have demonstrated that Congress genuinely appreciates the potential risks to beneficiary access if these cuts remain in place, and that we still have an opportunity for a longer-term solution when Congress returns.  Once again, we’ll be asking you to reach out to your legislators to make them understand the urgency of this issue for both your company, and the patients you serve.

Turning Up the Volume

While there’s still strong interest and engagement on this issue from our champions on the Hill, there will also be plenty of competing priorities on the Congressional calendar in September.  It’s clear that we will have to go beyond our previous efforts as an industry to date and raise the volume until this issue can’t be ignored – starting as soon as possible, and ramping up as members of Congress are back in their districts during August.

We’ll give you every bit of guidance, encouragement, and support we can to help make sure your voices are heard until we are finally able to get much-needed relief for rural providers and patients.  As long as the HME industry is ready to keep up the fight, AAHomecare will be standing by your side.

More Information and Resources for Grassroots Action

Support the Patient Access to Durable Medical Equipment (PADME) Acts in both the House (H.R. 5210) and Senate (S. 2736)!  Congress must act now to stop the spread of bidding to rural areas and keep this program from further decimating the home medical equipment safety net that supports some of our most vulnerable patient populations. 

Take Action Today!  Send an email to Congress here supporting common-sense fixes to lessen the impact of CMS' plans to apply bidding derived rates to rural communities and other areas not in competitive bidding areas.  Here are additional resources to help with your your lobbying and advocacy efforts:

Rural/Non-bid Area Relief Legislation Issue Brief

Organizations Supporting Rural Relief Legislation HME Industry Coalition Letter endorsing S. 2736 and H.R. 5210 ITEM Coalition Letter endorsing H.R. 5210 National Federation of Independent Business Letter Endorsing S. 2736 National Federation of Independent Business Letter Endorsing H.R. 5210

Regional Charts Detailing Rate Reduction by HCPCS Competitive Bidding Zip Code Analysis CB Regional and Rural Comparison PLAINS CB Regional and Rural Comparison SOUTHWEST CB Regional and Rural Comparison ROCKY MTN CB Regional and Rural Comparison MIDEAST CB Regional and Rural Comparison FAR WEST CB Regional and Rural Comparison SOUTHEAST CB Regional and Rural Comparison NEW ENGLAND CB Regional and Rural Comparison GREAT LAKES

Medicare Spending Chart

Evaluating CMS’ Outcomes Data Analysis For Competitive Bidding

CBA, Rural, and Regional Area Maps by State

CMS Plans Plans Fresh Cuts Through Competitive Bidding-Derived Pricing for Rural and Non-bid Areas

Medicare's so-called “competitive” bidding program for HME is having disastrous effects on both providers and their patients. Congress must act now to stop the spread of bidding to rural areas and keep this program from further decimating the home medical equipment safety net that supports some of our most vulnerable patient populations.  Read more about the background of the program in The History of the Competitive Bidding Program.

The Centers for Medicare & Medicaid Services has released rules which will reduce the prices in many home medical equipment categories nationwide based on prices derived from their badly-flawed competitive bidding program that is currently established in larger metropolitan areas around the country.

While it may seem reasonable to attempt to normalize costs for providers who are not included in these bidding areas, this new move by CMS will be especially burdensome for patients and home medical equipment providers in rural, less densely populated areas. 

In addition, while CMS’ bidding program for HME has largely turned out to be a train-wreck in the areas in which it’s been implemented, at least the companies that won their bids in this program were guaranteed a larger market share in conjunction with these reduced prices.  It is dangerous to saddle providers outside these bid areas with these bid-derived rates without a chance to bid, or without the benefit of increased market share – especially since many of these rural providers face higher delivery and associated service/repair costs based on greater distances in the areas they serve.

AAHomecare supports the Patient Access to Durable Medical Equipment (PADME) Acts -- S. 2736 and H.R. 5210, recently-introduced legislation on Capitol Hill that will provide relief for rural, non-bid-area HME patients and providers by:

  • Delaying the next round of cuts for rural and non-bid areas set to take place on July 1 for 15 months, so that CMS can properly assess the impact of the first round of cuts implemented on Jan. 1 of this year.
  • Setting the ceiling for future bidding rounds of the competitive bidding program at the unadjusted fee schedule rates in effect on January 1, 2015, instead of CMS’ proposal to set a bid ceiling at the previous bid amount rates.
  • Instructing CMS to revisit pricing adjustments for non-bid areas that takes into account travel distance, and other associated costs furnishing this equipment for prices that will be in effect on January 1, 2019.

Don’t let CMS double down on their badly designed competitive bidding system by applying these rate cuts to companies that don’t even get a chance to participate in the bidding.  Tell Congress we need a fix to the expansion of the bidding program today!

Take action, and spread the word with our easy-to-use grassroots tools:

We need Congressional offices to be hearing from their constituents on this issue. Numbers matter. Calls and emails educate policymakers, apply pressure, and swing key legislators to our side.

  • HME suppliers, manufacturers and other stateholders in our industry should go to action.aahomecare.org to send a message.  You can also find contact information to call your Members of Congress in our Congressional directory.

Forward action.aahomecare.org to everyone you work with and explain that our friends and colleagues businesses and livelihood are on the line - no one is immune from the impacts of these cuts. Ask them to visit the site and send an email to Congress telling them to stop the cuts.

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