HME PROVIDERS AND MANUFACTURERS URGED TO EXPRESS THEIR SUPPORT FOR DME ACCESS AND STABILIZATION ACT

THU, NOVEMBER 19, 2015

WASHINGTON, DC

Legislation to lessen the impact of the plans to drastically cut reimbursement rates for home medical equipment in rural communities has been introduced today in the Senate.  The new legislation, S. 2312, the DME Access and Stabilization Act, introduced by Sens. Senators John Thune (R-S.D.) and Heidi Heitkamp (D-N.D.), recognizes the unique challenges and expense associated with serving patients in less-densely populated areas nationwide.

“The home medical equipment suppliers and the communities they serve owe Senators Thune and Heitkamp a debt of gratitude for their leadership in spearheading this important legislation,” said Tom Ryan, President & CEO of the American Association for Homecare.

“This bill will protect access to essential home medical equipment products for seniors, as well as individuals with significant disabilities and chronic conditions, who reside in rural communities around the country,” Ryan added.  “I urge HME providers, manufacturers and other stakeholders in our industry to express their support for this legislation to their Senators as soon as possible.”

The legislation is especially timely, given plans by the Centers for Medicare and Medicaid Services (CMS) to apply prices derived from their competitive-bid pricing plan nationwide, subjecting suppliers who did not have the opportunity to participate in the bidding process to reimbursement reductions averaging 45 percent for many products.  CMS plans to begin implementation of these new cuts starting January 1, 2016.

S. 2312 includes provisions that:

• Apply a 30% positive adjustment to rural single payment amounts (SPA) (calculated on a national basis) for suppliers in non-bid, “rural” areas as defined by CMS.

• Apply a 20% positive adjustment to regional single payment amount (RSPA) for suppliers in all other non-bid areas.

• Provide a two year phase-in period for bidding derived pricing for non-bid areas.

• Set 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.

• Instruct CMS to revisit pricing adjustments for non-bid areas that takes into account travel distance, clearing price and other associated costs furnishing this equipment for prices that will be in effect on January 1, 2019.

• Effective January 1, 2020, new Medicaid allowable caps will be applied to the Federal portion of reimbursement that mirror the Medicare rates.  The rates for suppliers in competitive bid areas will match the Competitive Bidding Single Price Amounts (SPA), for rural areas will match the new rural single payment amounts (SPA+30%) calculated on a national basis, and for all other regions will match the new regional single payment amounts (RSPA+20%).

Additional co-sponsors at introduction included Sens. Pat Roberts (R-Kan.), Angus King (I-Maine), and Mike Crapo (R-Idaho).  Similar legislation is expected to be introduced in the House soon.

The American Association for Homecare represents durable medical equipment providers, manufacturers, and others in the homecare community that serve the medical needs of millions of Americans who require oxygen systems, wheelchairs, medical supplies, inhalation drug therapy, and other medical equipment and services in their homes. Members operate more than 3,000 homecare locations in all 50 states. Visit www.aahomecare.org.