Page 22 - HME Business, March 2017

LEGISLATIVE OUTLOOK:
Fingers Crossed!
The HME industry is feeling something it hasn’t felt in some time: hope. With the arrival of a new Presidential administration and a new Congress, providers are crossing their fingers that they might finally have a real chance at reversing policies that have been hammering their businesses and patients for years.
The HME industry has faced a seemingly endless array of obstacles when trying to make its voice heard on Capitol Hill. Competitive bidding seemed to be a fact of life so deeply etched in stone that the Centers for Medicare and Medicaid Services carried itself as though it was completely opposed to working with the industry on any element of the policy. Add to that an avalanche of claims audits and other reimbursement cuts, and the industry’s prospects looked bleak indeed.
But given that most in the industry are enterprising, entrepreneurial individuals who are willing to go the extra mile, they still kept advancing the industry’s agenda. And that strategy paid off in recent years. While the goal might have been to repeal competitive bidding and replacement it with something better, such as the Market Pricing Program, the industry was still able to chip away at competitive bidding bit by bit.
A good example of how those efforts paid off were the binding bids legislation, which required bidders to obtain a “bidding bond” that func- tions like a surety bond. If a bidder declines the contract and its bid was at or below the bid price, then that bidder would forfeit its bond. This removed the extremely harmful problem of “suicide bidding” from the program, and vindicated literally years of hard-fought industry efforts on Capitol Hill to reform at least one piece of the faulty competitive bidding program.
But while the industry has been gaining victories, it is still stuck with a competitive bidding program that remains dysfunctional on a good day.
A perfect example of that is the national expansion of competitive bidding, which has hurt rural patients and providers alike. While the CURES Act
helped give providers a temporary reprieve, for example, there is still much work to be done to ensure rural patients will still have access to HME.
Which is why the resetting of the political and regulatory chessboard couldn’t come at a better time. Now that the scenario is offering HME providers some much-needed hope and optimism, what should be the industry’s legislative priorities?
A Public Policy Re-Think
Before we dive into specifics, it’s important that we take a moment to reassess the situation. Much of the industry’s recent woes have stemmed from competitive bidding. Bearing that in mind, one of the big factors to remember about competitive bidding is that in many respects, the entire program is a perpetual blank canvas. In fact, the program under which the industry has been working for the past several years is mainly the devising of CMS. While the Medicare Modernization Act, enacted way back in 2003, required a competitive bidding program for Medicare’s DMEPOS suppliers, it didn’t go too deep into the “how” of that program, and left the specifics largely up to CMS.
“CMS has huge amounts of discretion, and none of the details are in statute,” says Cara Bachenheimer, senior vice president of Government Relations for Invacare Corp. “In theory, the whole program could be rewritten under new administration.”
That’s an important consideration to keep in mind, because for the first time in a long time, the industry finally has something in CMS that it hasn’t had in a long time: friends. Well, to be more specific, it has an agency that will be willing to work with the industry now that it is under new management.
The new Secretary of Health and Human Services, longtime industry ally and up until recently Rep. Tom Price (R-Ga.). As a lawmaker, Price was the prime mover behind the legislative push to repeal competitive bidding
20 HMEBusiness | March 2017 | hme-business.com
Management Solutions | Technology | Products
Now that a ray of hope has shined on the industry’s prospects on Capitol Hill, what will be HME’s legislative agenda in the months to come?
By David Kopf