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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 legislation to provide relief for suppliers in CB areas though H.R. 6641, would establish a 90/10 blended rate (90% competitive bidding rates/10% unadjusted Medicare fee schedule rates.  We are also working with Senate leadership to build support for extending the current 75/25 blended rate for non-rural, non-CB are suppliers beyond the end of the PHE.  Learn more about these twin advocacy efforts below.

Relief for Suppliers in CB Areas/HR 6641

On February 8, Reps. Markwayne Mullin (R-Okla) and Paul Tonko (D-N.Y.) formally introduced HR 6641, the DMEPOS Relief Act of 2022. The new legislation applies a 90/10 blended Medicare reimbursement rate for items in the 13 product categories whose bid results were not implemented in Round 2021.  These increased rates would apply from Jan. 1 2022 through Dec. 31, 2023.

Other House members joining the bill as original cosponsors include Brian Fitzpatrick (R-Pa.), Fred Keller (R-Pa.) Frank Mrvan (D-Ind.), Tom Reed (R-N.Y.), and Terri Sewell (D-Ala.). Updated co-sponsor list can be found here.

Help build additional  support for this legislation by asking your Representative in the House to co-sponsor this legislation – follow the steps below to send a concise, effective message to your Representative asking them to sign on.

The most important step you can take today: e-mailing your Representative’s healthcare staffer asking them to co-sponsor HR 6641, the DMEPOS Relief Act of 2022.

Step 1 – Who to contract.  
If you don’t know the name and email address of the staffer who handles healthcare issues for your Representative, 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 Representative here.

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 the current Medicare reimbursement rates are impacting 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: Reps. Markwayne Mullin and Paul Tonko have just released HR 6641, legislation that will provide a modest increase to Medicare reimbursement rates until CMS can initiate a new competitive bidding round.  Please co-sponsor the legislation – contact Rep. Mullin’s or Rep. Tonko’s office to sign on.  A draft of 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 Rep./staffer as part of AAHomecare’s virtual 2021 Washington Legislative Conference on Sept. 29?  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.

Was your Representative one of the 95 House members who joined the October 2021 sign-on letter asking CMS to engage with HME stakeholders on Medicare reimbursements?  If so, thank them for signing on and ask that they reaffirm that support for the sustainable reimbursements by signing on as a co-sponsor.  See full list of signers here.

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.

Note: If a staffer’s reply cites the 5% CPI adjustment granted by CMS in December as a reason for not supporting additional relief, please make the point that a 5% adjustment does not begin to cover how much product and operational costs have changed for your company since the last implemented bidding round in 2015.  Feel free to note specific product/shipping cost increases or new operational costs, such as PPE requirements that you are incurring. The 5%-relief-is-sufficient fallacy needs to be strongly countered!

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.

Extending the 75/25 Blended Rate in Non-Rural, Non-CB Areas

AAHomecare and other industry stakehoders are working with HME champions on the Senate side to build support for extending the 75/25 blended rate beyond the end the COVID-19 PHE.  While there currently is no active legislation with this provision, we encourage suppliers who have a chance to meet with their Senators over the next few weeks to request that they support extending current relief for non-rural, non-CB area suppliers.  If your Senator is on the Finance Committee, these preliminary contacts are especially important. Please contact us (see below) if you would like help setting up a meeting or call with your Senator(s) 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!