President's Message: What's Next for the HME Industry?
An Insightful Summary from Tom Ryan, AAHomecare Pres/CEO
As we start the New Year, with a new Congress just getting settled in and a new Presidential Administration beginning in just a couple days, AAHomecare has hit the ground running to ensure we can build on last year’s legislative and regulatory successes and capitalize on potential opportunities for even better public policy outcomes for HME in 2017. I’d like to give you a quick rundown on what we’ve been focusing on at the start of the year to make that happen.
Rural O2 Payment Policy – As we've recently reported, AAHomecare has asked CMS to reconsider their changes to the 2017 fee schedule for stationary oxygen, resulting from the misguided combination of a 2006 offset balancing rates for portable and stationary oxygen with bidding-derived pricing for rural providers. While we’ve continued to attempt to engage CMS on this issue, we are now reaching out to Capitol Hill to alert them to this issue and ask them to get involved and are also planning media/PR outreach on the issue if it not quickly resolved.
Competitive Bidding Program – Last year’s success in getting a measure of relief for rural providers for July through December of 2016 will certainly be welcomed by providers when CMS finally announces a refund process (more on that in a moment), but a longer-lasting solution is critically needed. While our champions on Capitol Hill have expressed their willingness to take up the fight for fairer rural relief policy in the 115th Congress, we’re all too aware of how slowly that process can move. To that end, we brought in a sub-group of AAHomecare’s Regulatory Council to explore and develop regulatory actions the new administration could take to provide relief for rural providers, especially given that the recent CURES legislation will require HHS to reissue payment regulations to take effect by the start of 2019.
Reimbursements from Other Payers – We believe that other payers who base their rates on the Medicare fee schedule should provide commensurate retroactive relief for the July 1-Dec. 31 period, where applicable. We are currently working on our messaging to make this case to TRICARE and Medicare Advantage plans.
Where’s the Refund? – As I noted above, HME providers in rural and non-bid areas are anxiously awaiting word on the procedures and timing for the relief mandated in the CURES Act – it’s certainly a question that the AAHomecare staff has heard repeatedly from our members and other HME stakeholders. We’ve pressed CMS to provide guidance as soon as they can, and you can be sure we’ll share that news with you as quickly as we get it.
We’re Just Getting Started – While AAHomecare helped deliver important gains for the HME community in 2016, we recognize that the HME industry still faces a reimbursement and regulatory environment that is causing many well-established companies to change their business models or shutter their operations – leaving patients and communities with less access to essential home medical equipment. Be assured that the current AAHomecare team enters 2017 with a renewed commitment to improving the business environment for HME through continued advocacy work on Capitol Hill and at CMS, by building relationships with non-Medicare payers, and by exploring new approaches to reimbursement models for value-based approaches and emerging technologies. I truly believe this will be our most productive and effective year yet, and I look forward to working with the AAHomecare membership and other HME stakeholders to make it happen.