H.R. 5555 Provides 90/10 Blended Rate in CBAs; 75/25 Rate for Non-Rural/Non-CBA Suppliers
New legislation providing relief for suppliers across a broad range of patient segments was introduced yesterday by Reps. Mariannette Miller-Meeks (R-Iowa) and Paul Tonko (D-N.Y.). The DMEPOS Relief Act of 2023 (H.R. 5555) provides a 90/10 blended Medicare reimbursement rate (90% adjusted payment rate/10% unadjusted fee schedule rate) for most home medical equipment products in Competitive Bidding Areas (CBAs), effective Jan. 1, 2024, through the end of 2024. Language in Section 3 of the legislation also has the effect of extending the current 75/25 blended rate in effect for non-rural/non-CBA suppliers though 2024.
“This legislation provides a long-overdue relief for HME suppliers serving Medicare beneficiaries in CBAs, who have been saddled with reimbursement rates that have not seen a meaningful, market-based adjustment since 2015,” said Tom Ryan, AAHomecare president & CEO. “These modest rate increases will help stabilize the HME supplier base and provide better access to high-quality home-based care for millions of Americans and their caregivers.”
“The timing of this new legislation couldn’t be better, with more than 200 meetings with members of Congress set for tomorrow [Sept. 20] via our Virtual Washington Legislative Conference,” added Ryan. “The HME community at large needs to follow on these meetings with concerted grassroots advocacy over the next few weeks to build support for this legislation in the House, as well as for S. 1294 in the Senate.”
“Today’s legislation also underscores the need for a longer-term solution to make sure Medicare reimbursement rates reflect the rising product and operational costs facing the HME community,” added Ryan. “We need policymakers to understand the critical need to make sure our industry operates under a sustainable rate structure to meet the needs of a rapidly growing senior cohort.”
See bill text for HR 5555 and our related Issue Brief to learn more. AAHomecare will share additional information and updated grassroots advocacy guidance after the Sept. 20 virtual legislative conference.