Page 12 - HME Business, September/October 2020

We still don’t have any kind of rule, and the interesting thing about that is whether that’s related to Round 2021 being paused beyond January 2021, or if there’s difference in the payment rates. Now, obviously, the CARES law payment rates — the higher rate that Congress legislated early this year at the end of March — are in effect for the duration of the public health emergency. So any payment rule that CMS puts out is essentially, overridden. The statute takes precedence over CMS, so CMS don’t necessarily have a say in the matter as long as the public health emergency is around. But we don’t know how long that’s going to last.
At this point, it’s really too late for CMS to put out a proposed rule with a 60-day comment period.
If they even came out with it today, the 60-day comment period would be end of November. They could do a 30-day comment period, which they did for some of the rules that they were laid off, but that means end of October. And then they would have to turn around a final rule to make it effective Jan. 1. Or, they could do an interim final rule. So there are processes, but right now it’s a big question mark.
KEEP ADVOCATING FOR H.R. 2771
Tom Ryan, president and CEO of the American Association for Homecare
We continue to work with Congress and pressure CMS delay competitive bidding. As of late September, we reached out to CMS again, and they still have not made a decision regarding the payment rule or delaying
Round 2021. Basically, we’ve been in a gap period right now for two years. The last rule that came out continued with the 50/50 blended rate, which was relief we had in previous legislation, and an interim final rule. Now with competitive bidding ready to start again in 2021, although we are advocating for them to delay it, there’s going to be some kind of rule that should be coming out that would tell us what the rural and non-bid rates would be.
We’ve got pressure in the House and the Senate to delay competitive bidding. We had a House initiative with 101 members signed off on, and we’re working with Senate leadership, not only to pressure CMS to delay it.
We’re working with the House and Senate to pressure OMB to release the rule. And once that rule comes out, depending on what is in it, then we have to continue to work with Congress to get relief for the non-competitive bidding areas.
Obviously, we have H.R.2771 out there, which gives relief in the non-CBAs, and we have to continue to advocate that. We have relief and a public health emergency now for both non-CB and rural areas, the 50/50 and the 75/25. We certainly believe the public health emergency is going to last through the end of the year. But
if the rule does not come out, and it does not appropriately address rural relief. That’s some- thing we will have to focus on through H.R. 2771.
Advancing H.R. 2771 continues to be a grass- roots effort. The more co-sponsors that are garnered, the better. Now, with a new Congress that will lapse, and then you have work with the new Congress to drop the bill again. So when you’re looking out over the next several months, this bill still exists in Congress. We have to be prepared that, when that public health emer- gency relief ends, that there’s a legislative vehicle to get us some relief in the non-bid areas, and that exists in 2771.
SUPPORT INDUSTRY ADVOCACY EFFORTS AND ASSOCIATIONS
Steve Ackerman, CEO of Spectrum Medical Inc.
Advocacy on behalf of the HME industry is facing interesting times. Operating in the COVID19 pandemic and a long-awaited announcement about when and how competitive bidding moves forward are the prevailing issues
on the minds of most suppliers.
The election and what can only be described
as a mess in Congress has presented a number of challenges for the industry’s leading advocates at AAHomecare.
Finding moving legislation, to which we can attach industry-specific bills, is the no. one priority. There is hope that later in the year, the opportunity will present itself to move forward the four current bills affecting the industry. (They can be reviewed
at aahomecare.org.) The legislative team at AAHomecare is in touch with lawmakers and regula- tors on a daily basis moving the needle for all of us.
If individual providers do nothing else, please take this opportunity to support AAHomecare efforts by joining. The industry is finally speaking with one voice and needs everyone benefiting to be on the team and involved.
EXPECT REGULATORY CHANGES
Jeff Baird, Esq., chairman of the Health Care Group at law firm Brown & Fortunato, P.C.
Because of COVID-19, the legal landscape for HME suppliers during the latter part of 2020 and moving forward is littered with uncertainty and possibility. There exist continued negotiations regarding additional government
aid and relief programs to assist providers/ suppliers during the pandemic. There is uncer- tainty surrounding how long existing waivers and regulatory relaxation may last. The inevitability of investigations and criminal charges for those defrauding the government and patients has already started. HME suppliers need to be aware of each of these issues and prepare for a 2021
that will likely be anything but normal.
We know that Congress is continuing to debate and politicize additional business relief programs,
like an additional round of PPP funding. What seemed likely to occur a few months ago is a great unknown now as the U.S. has shifted to presidential election mode. While there are still efforts at additional programs, cooperation and compromise may be impossible during what will likely prove to be one of the most contentious election cycles ever seen. Consistent with this theme, HHS has further delayed the reporting requirements of the Provider Relief Fund,
now pointing to an early 2021 reporting date. Unfortunately, at this point, it seems likely that additional programs will also be delayed in favor of election cycle political brinksmanship.
HHS, Congress and President Trump (via executive order) provided an unprecedented number of waivers and regulatory framework changes to allow new and existing health care providers/suppliers to continue to do business during the pandemic. One example of these changes includes the rapid expansion of tele- health, including the types of providers who may provide telehealth services, the types of tele- health services that may be billed, the technology that may be used during a telehealth visit and the locations where both patients and providers may be located during a visit.
It is not yet clear how many of these changes may be rolled back or when such a rollback may occur, but all providers/suppliers should be on the lookout. Other important waivers that are already seeing regulatory drawbacks include procedures for new provider enrollment as well as requirements for surveys and audits. If the pandemic subsides, we can expect increasing surveys and audits moving forward.
CONSIDER CURBSIDE SERVICE
Rob Baumhover, Director of Retail Programs for VGM Group Inc.
One sales trend that the majority of providers have seen increase tenfold over the last six to eight months is phone orders requesting and expecting curbside pickup and home deliveries, as well as their
e-commerce business.
I believe providers need to analyze how they
sold to their customers six to eight months
ago vs. the way they do today and spend some resources on making their current way better, as I feel it’s going to be the norm for quite some time and well into the future.
We need to make it as easy as possible for customers to purchase from us, so update and add to your e-commerce site, train sales staff to treat phone transactions like in-person transac- tions by qualifying the customer to add on sales
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