Copy
View this email online
Logo
  06/01/16
Legislative Update
Fight to Get Rural Relief Legislation Passed Enters Final Month
Powerful Tools in Your Arsenal to Fight for PADME Bills
The count is at 30 days until the July 1 cuts take effect, and AAHomecare is calling the HME community to commit to making every last effort to encourage Congress to support legislation for rural relief—The Patient Access to Durable Medical Equipment (PADME) Acts, H.R. 5210 and S. 2736. 

You’ve done a great job building momentum, but we are now headed toward the critical final weeks that will decide the issue. As the Industry descended on Capitol Hill and lobbied hard for Congressional support of Competitive Bidding reform last week, our consumer and industry partners bolstered our endeavors with letters of support. A joint letter from national and state associations in support of PADME explains that little independent analysis of the competitive bidding program has been done to evaluate whether the program has “restricted the types of products available for patients or compromised physician decisions to prescribe specific products…” 
 
The ITEM Coalition has endorsed H.R. 5210, and the National Federation of Independent Businesses has weighed in with letters supporting both the Senate and House bills.  We encourage you to share these letters with your Congressional members as examples of support from patients and industry associations.  You can also share maps showing rural, regional, and CBA areas in your state.


The HHS OIG also released a chilling report confirming that CMS awarded unlicensed bidders to receive contracts in Round Two (more details in next story), that can also help you make the case that current Round 2 rates that helped determine bidding prices for some rural and non-bid regions are based on winning bids from unqualified bidders.

Each of these are powerful tools in your arsenal to fight for rural relief legislation and help swell Senate & House co-sponsor rolls.  We encourage you to use everything at your disposal in these final days to help us push legislation into a vote.  
 
Are your Senators and Representative on the list?

New House co-sponsors in the last week:

Rep. Jeff Fortenberry (R-Neb.)
Rep. Kurt Schrader (D-Ore.)
Rep. Pete Visclosky (D-Ind.)
Rep. Ed Whitfield (R-Ky.)
Rep. Chellie Pingree (D-Maine)
full House co-sponsor list (total: 72)

New Senate co-sponsors in the last week:

Sen. Tammy Baldwin (D-Wisc.)
Sen. Mark Kirk (R-Ill.)
full Senate co-sponsor list (total: 29)
OIG Report
OIG Report Confirms Licensure Problems in Round 2 Bidding

On May 26, the Department of Health & Human Services Office of Inspector General (OIG) published a report titled, “Incomplete and Inaccurate Licensure Data Allowed Some Suppliers in Round 2 of the Durable Medical Equipment Competitive Bidding Program That Did Not Have Required Licenses.” Through the research, OIG found that out of the 146 contract winners they reviewed, 63 suppliers did not meet licensure requirements. In addition, OIG was not able to determine 14 of the suppliers’ credentials to know whether they met licensure requirements or not. OIG also found that CMS, National Supplier Clearinghouse (NSC), and Competitive Bidding Implementation Contractor (CBIC), do not have an accurate licensure database. OIG recommended that CMS review the 14 identified contract winners on their qualifications, identify all state licensure requirements, and coordinate with State licensing boards to update the licensure database.
 
The OIG also speaks to dollars paid to unlicensed contract winners as amounting to 0.58% of total dollars paid.  However, the issue is not what was paid but that unlicensed suppliers were allowed to bid and the pricing they submitted was used to create the single payments amounts (SPAs). Unlicensed bidders did not bear the costs of being licensed and were not in compliance in Competitive Bidding Areas (CBAs); therefore, their bid prices could be lower and in turn artificially lower the SPAs not only in these states and CBAs where they were located, but now throughout the country with the rollout of CBA pricing to non-CBA areas.
 
Because Round 2 will be completed on June 30, at a minimum, the rollout of the CBA pricing to the entire country should be delayed, since the Round 2 SPAs were the largest component of the CBA pricing rollout that began on January 1, 2016. 
 
You can view AAHomecare’s summary of the OIG report here.

Legislative Conference Recap
Washington Legislative Conference Culminated in More than 225 Meetings on Capitol Hill

On the heels of last week's Washington Legislative Conference, the momentum is building for support of rural relief legislation. On Wednesday and Thursday, conference attendees met with more than 225 legislators' offices to discuss the Patient Access to Durable Medical Equipment (PADME) Act of 2016 and other advocacy priority issues.
 
Not only did the conference give suppliers and manufacturers the time to spend on the Hill, but it also provided key issue education to ensure everyone was prepared for the questions they received when speaking about the pay-for and other attributes of the legislation. 
 
Attendees also heard from Peter Thomas, of the ITEM Coalition, who announced during the conference that the ITEM Coalition supports PADME.  Representing over 70 consumer groups, the ITEM Coalition has a powerful and well respected voice on The Hill.  Thomas' rallying speech opened the conference and was followed by the general session which included a discussion on the challenges faced by rural providers. The rural panelist explained they have cut all the corners they can. Their challenges include thousands of miles of territory with rising gas prices, dirt roads, unfavorable weather conditions and other opposition to allowing profit. 
 
During the PAC Reception on Wednesday evening, AAHomecare’s president, Tom Ryan, presented the AAHomecare/Mal Mixon Legislative Advocate Award to Thad Connally, president of First Choice Home Medical in Bowling Green, Ky., and the president of the Kentucky Medical Equipment Suppliers Association. Connally’s advocacy efforts are evidenced by the recognition and credibility he has established throughout the Kentucky congressional delegation, from its most junior members all the way to the office of the Senate Majority Leader.  The award was given in recognition of Connally's contribution of time, energy, and resources in helping protect and defend the business of homecare. As an active AAHomecare member, he has demonstrated it is not necessary to be “inside the Beltway” to be an ardent and effective lobbyist for homecare.  Connally (right) is pictured with Tom Ryan and Rep. Brett Guthie (R-Ky.) who was on hand to see Thad receive the honor. 


Congressional speakers included Marsha Blackburn (R-Tenn.) and Renee Ellmers (R-N.C.) who agreed that should cuts take place on July 1 it will hurt patients and providers. The Congresswomen provided tips for speaking with members of Congress and their staff about the pending legislation.
 
For further analysis of the conference and pictures of the event, please search Twitter for #WLC16 or #aahomecare. Congratulations to the winner of the #WLC16 Photo Sweepstakes, Gary Sheehan (@gmsheehan) of Cape Medical, in Cape Cod, Mass, (shown below far right with Senator Jack Reed (D-RI) and Dana Lesperance) who provided continuous updates of his experience in Washington, D.C. through Twitter. 
 
As first time conference attendee Dana Lesperance of Absolute Respiratory Care in Rhode Island said, "Traveling to D.C. for the AAHomecare conference and congressional meetings on Capitol Hill was a fulfilling experience. The value can’t be overstated. AAHomecare, along with HOMES, the regional organization Absolute Respiratory Care belongs to, took the guess work out of the logistics of the congressional meetings. This enabled me to focus on networking and preparing for my scheduled meetings. The return on investment does have some instant gratification when you hear one of the representatives you met with signed on to a bill. I do believe we are laying the groundwork for a more long-term and long-lasting return. I can recommend, without hesitation, taking a couple days to participate in the conference and the legislative process. As a first-timer, I was left asking why I haven’t attended for years? It goes without saying, the time is more important than ever to be active. The cuts on July 1 will have a negative impact on our company and on Medicare beneficiaries."


Thank you to those all who attended the Washington Legislative Conference and represented the HME community on Capitol Hill. 

What's Happening
AAHomecare in Action

Jay Witter, senior vice president of public policy, and Ashley Plauché, government affairs manager, met with Sen. Ron Wyden (D-Ore.) as part of Washington Legislative Conference (WLC) Hill appointments… Witter also met with Sen. Ben Cardin (D-Mary.) and Rep. Don Beyer (D-Va.)… Plauché met with Reps. Earl Blumenauer (D-Ore.) and Bob Dold (R-Ill)… Kim Brummett, vice president of regulatory affairs, joined North Carolina WLC attendees for meetings with Sen. Richard Burr (R) and Reps. David Rouzer (R), Renee Ellmers (R), Mark Meadows (R), G.K. Butterfield (D), George Holding (R), Patrick McHenry (R), and David Price (R)... Brummett and Mina Uehera, regulatory affairs manager, attended a CMS public meeting on HCPCS Codes… AAHomecare hosted receptions for Reps. Dave Loebsack (D-Iowa), Tim Murphy (R-Pa.), and Pat Tiberi (R-Ohio)

The State Leaders Council, Complex Rehab & Mobility Council, and HME/RT Council all convened at the WLC… 

 
HME Education

Oxygen: When do the 36 Months Start Over?
Webinar - Monday, June 6 at 2:30 pm

When a DME supplier provides an oxygen concentrator to a Medicare beneficiary, Medicare will pay the supplier for the first 36 months and then the supplier will be obligated to service the beneficiary’s oxygen needs, for no additional compensation, for the next 24 months. 
 
Occasions may arise when the beneficiary’s continuous use of the concentrator is interrupted. This interruption may be caused by one of the following: 

  • The concentrator is lost, stolen, or damaged beyond repair; 
  • There is an extended break in need of greater than 60 days; 
  • The supplier sells its assets to another supplier; 
  • The supplier goes out of business; 
  • The supplier files for bankruptcy; or 
  • The beneficiary relocates outside the supplier’s service area. 

When one of these events occurs, and afterwards the beneficiary subsequently starts using a concentrator provided by the initial supplier or a concentrator provided by a new supplier, the question becomes: Can the 36-month rental period start over?

Lisa Smith, of Brown & Fortunato, will discuss these situations and answer your questions during the “Oxygen: When do the 36 Months Start Over?” webinar on June 6 at 2:30 ET.  
 
Fees:
Members: $99.00
Non-members: $129.00
Register today!


Mid-Year Audit Updates
Webinar - Monday, June 20 at 2:30 pm

This webinar provides an update to the supplier community on what the current audit environment looks like. Audits continue to have a powerful impact on the DMEPOS industry, and the focus and actions of the auditors continuously change. Attendees will receive an overview of changes that will impact their business and also what they need to know to identify internal risks and vulnerabilities. They will also learn current legislative and regulatory remedies that could lessen the overall impact of audits on our industry as well as information on how they can help in promulgating changes to the audit system.

Learning Objectives

  • Identify what changes are occurring in the audit environment that will impact suppliers.
  • Review vulnerabilities that increase a supplier's risk of audits.
  • Summarize current regulatory and legislative remedies to ease audit impacts.
  • List tools a supplier can utilize to minimize the impact of audits
Wayne van Halem, of The van Halem Goup, will discuss these situations and answer your questions during the “Mid-Year Audit Updates” webinar on June 20 at 2:30 ET.  


Fees:
Members: $99.00
Non-members: $129.00

Register today!

Member Benefit

Exclusive Discounts on Medicare/Medicaid Surety Bonds and Liability Insurance

AAHomecare members are eligible to receive a 10 percent discount on Medicare/Medicaid Surety Bond premiums and General and Professional Liability insurance offered by VGM Insurance.  For more information or to start the quote process, visit www.vgminsurance.com/AAH or call VGM Insurance at 800-362-3363.

 
 

AAHomecare Corporate Partners
 



            

         

        

Email:info@aahomecare.org  
Copyright © 2016 http://www.aahomecare.org, All rights reserved.
Wednesday in Washington is an AAHomecare Member Benefit. Forward to others in your company.
Not interested? Unsubscribe from our list.