Page 24 - HME Business, March 2017

Fingers Crossed!
the executive committee of National Coalition for Assistive & Rehab Technology, the first two priorities are to extend the industry relief that was provided in the CURES bill ... and to secure permanent relief of the competitive rehab accessories.”
CURES Act & Rural Relief
There is no more pressing problem than helping the providers and patients that have been cast adrift by national bidding expansion. Last year the industry was unable to turn back the bid expansion. The Patient Protection/ Affordable Care Act, required that competitive bidding prices be used to determine reimbursement for bidding items in all non-bid areas starting on Jan. 1, 2016. The process was to be phased in with partial rate cuts occur- ring at the start of that year, and the full rate cuts were to be implemented on July 1, 2016.
No matter what the industry tried leading up to that point, it was unable to stop the bid expansion. Last-minute legislative pushes saw the House and Senate pass delays to the bid cuts on two occasions, but completely unforeseen circumstances such as a Congressional sit-in over gun control scuttled attempts to forestall the rural bidding cuts.
The full cuts went into implementation and rural providers were hit hard. Now providers serving patients in remote areas were forced to shutter businesses, or at least refuse to take on additional Medicare patients. Also, a ripple effect started to be felt across programs such as TRICARE, which bases its DME reimbursement on Medicare rates. Things looked grim for those providers and their patients.
But suddenly the industry was given a lifeline. In December, the industry was able to achieve some relief for rural providers and patients. Congress
passed the CURES Act, which President Obama then signed into law, which retroactively sets the implementation date for the full bid expansion cuts to Jan. 1, 2017. Providers will be reimbursement for the additional amount taken from DMEPOS claims made after July 1, 2016 and before the start of this year.
This was helpful, but the full rates were back into effect on Jan. 1, which left rural providers and patients right back at square one. Fortunately, the industry is now in a position to work with CMS on some immediate fixes, while new rules come into play. In statute, CURES requires that there be a reissuing of the rules specific to rural providers. Those rules would not come into effect until the next round of competitive bidding a year and a half from now, and in the meantime CMS can alter how it handles the bid expansion pricing. An easy fix is to go back to the transitional rates that CMS applied during the first six months of the expansion.
“We’re hoping that a lot of the fixes to the program are going to be developed in a regulatory payment environment,” says Tom Ryan, president and CEO of the American Association for Homecare. “That’s the whole idea of trying to work with the agency now that we have Price’s leadership on-board.
“Obviously, number one is to go back to that blended rate in effect,” he continues. “Let’s go back to rate that was Jan. 1 that was still a hit for the industry, but it was livable, and then let’s have new rulemaking come into play some of the things that were specified in CURES, such as travel, number of providers in the area, and so forth.”
But the industry isn’t taking any chances. While it readies itself to work with the new HHS and CMS leadership, it is also working on a legislative approach to protect rural providers.
“Oh we have to have our champions in line,” Ryan says. “And absolutely
there is a feeling among our champions that the six months that have
come and gone were not enough, more needs to be done, and they’re
poised to help us.
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22 HMEBusiness | March 2017 | hme-business.com Management Solutions | Technology | Products