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  03/30/16
Legislative Update
Critical Weeks Ahead for Rural Relief and Bid Ceiling Fix Legislation
With a July 1 deadline looming for additional Medicare reimbursement cuts for suppliers in rural and other non-bid areas, there’s an urgent need to get House companion legislation to S. 2736 introduced with a strong round of original co-sponsors.  Our champions on Capitol Hill are especially looking for support and co-sponsorship from members on the House Energy & Commerce Committee when the legislation comes out shortly after the House returns from recess on April 12.

If you are represented by any of the individuals on the committee please make a personal contact by April 7 with their DC or district offices, asking for an individual who handles healthcare related issues.  In your contacts, you should:
  • Tell these individuals about the effect that the competitive bidding program is having on your business and your patients, and ask that the Representative contact Rep. Tom Price’s office to co-sponsor upcoming companion legislation to S. 2736. 
  • Inform them that this legislation will freeze the next round of upcoming cuts for rural home medical equipment providers until CMS fairly assesses the effect of previous reimbursement reductions on patient health, and makes other adjustments to the competitive bidding program methodology.
Members of the Energy & Commerce Committee are listed below – individuals with a “yes” in the 4185 column are current co-sponsors of H.R. 4185, which provides adjustments for rural and non-bid area providers and also fixes the bid ceiling mechanism for future bidding rounds.  While H.R. 4185 technically remains active, the implementation of the first round of cuts that has already taken place has diminished the potential effectiveness of that bill.  However, it is still a good indicator for those who might be inclined to support the companion legislation that is about to be introduced in the House.
 
  State   Republicans   4185   State   Democrats   4185
FL Gus Bilirakis Yes CA Tony Cardenas  
IN Larry Buchson Yes CA Lois Capps  
IN Susan Brooks Yes CA Anna Eshoo  
IL Adam Kinzinger   CA Doris Matsui  
IL John Shimkus   CA Jerry McNerney  
KS Mike Pompeo   CO Diana DiGette  
KY Brent Guthrie Yes FL Kathy Castor  
KY Ed Whitfield Yes IL Bobby Rush  
LA Steve Scalise   IL Jan Schakowsky  
MI Fred Upton, chairman   IA Dave Loebsack Yes
MO Billy Long Yes KY John Yarmuth  
MS Greg Harper Yes MA Joe Kennedy III  
NC Renee Ellmers Yes MD John Sarbanes  
NC Richard Hudson   NC G.K. Butterfield  
ND Kevin Cramer Yes NJ Frank Pallone  
NJ Leonard Lance   NM Ben Luján  
NY Chris Collins   NY Yvette Clark  
OH Bill Johnson Yes NY Eliot Engel  
OH Bob Latta Yes NY Paul Tonko  
OK Markwayne Mullin   OR Kurt Schrader  
OR Greg Walden   PA Michael Doyle  
PA Tim Murphy   TX Gene Green  
PA Joe Pitts   VT Peter Welch Yes
TN Marsha Blackburn Yes      
TX Joe Barton        
TX Michael Burgess        
TX Pete Flores        
TX Pete Olson        
VA Morgan Griffith        
WA Cathy McMorris Rodgers Yes      
WV David McKinley        

As you can see, support on the Republican side for H.R. 4185 was considerably stronger, so extra efforts on the Democratic side will be particularly helpful this time around.   Of course, support and cosponsors are welcome from every corner of Capitol Hill, so please contact your Representative even if they’re not on this list.   You can also see the complete cosponsor list for H.R. 4185 here.

While direct engagement with legislators and their staff members is the most effective means to advocate for better public policy for HME, you can also send an email here in support of S. 2736 and House companion legislation.
  

With the cuts we’ve seen in the Round 2 Recompete bidding results, the bidding program continues to ratchet up the pain for HME providers and patients everywhere.  This new legislation will help limit the cuts for rural providers, while forcing CMS to assess and report on the program’s effects on beneficiary access and also removing the ever-downward-pressing bid ceiling CMS envisions for future bidding rounds.  This is a win we need for the entire HME sector.  

We have a great Senate bill with strong co-sponsorship already out there – now the task at hand is to build on this promising start by helping generate strong support for a House counterpart.   Whether you’re an experienced advocate for HME or a relative newcomer to contacting your legislators, the time for action is now.
Round 2 Recompete
Round 2 Recompete: Price Reductions Found in Nearly Every Category
Last week, we shared our analysis of results of the Round 2 Recompete (covering Enteral Equipment and Supplies, Enteral Nutrition, NWPT Supplies and NWPT Pump, and Hospital Beds). Here is a rundown of all major categories, presented in terms of change between the new Round 2 Recompete rates vs. the Round 2 rates currently in effect.  Our calculations show an average overall 7.1% decrease in prices when compared to Round 2 prices; the handful of categories that showed modest increases are highlighted in blue.
 
% CHANGE PER CATEGORY MIDWEST NORTHEAST SOUTH WEST TOTAL
CPAP -13.7% -16.7%  -14.1% -15.6% -14.9%
OXYGEN               -13.8% -15.1% -13.4% -13.6% -13.9%
RAD -4.4% -9.9% -6.9% -7.7% -7.2%
CPAP/RAD ACCESSORIES AND SUPPLIES -6.5% -8.0% -6.7% -8.3% -7.2%
ENTERAL EQUIPMENT & SUPPLIES -6.5% -2.4% -4.8% -3.4% -4.4%
ENTERAL NUTRITION -6.1% -5.7% -5.7%       -4.4% -4.6%
HOSPITAL BEDS MANUAL 0.4% 3.4% 0.2% -1.4% 0.7%
HOSPITAL BEDS SEMI-ELECTRIC -13.2% -13.5% -8.6% -12.3% -11.9%
HOSPITAL BED ACCESSORIES -4.8% -3.4% -4.0% -8.2% -5.1%
WALKERS 11.2% 2.0% 5.4% 2.9% 5.4%
MANUAL WHEELCHAIRS -9.8% -20.2% -8.0% -14.7% -13.2%
POWER WHEELCHAIRS -3.7% -6.1% -3.5% -6.6% -5.0%
SCOOTERS -2.2% -0.6% 1.8% -4.8% -1.5%
SEAT CUSHION -1.1% -3.1% -0.9% -4.9% -2.5%
WHEELCHAIR ACCESSORIES 3.2% -0.2% 1.0% -1.9% 0.5%
NPWT SUPPLIES 4.1% 3.0% 1.9% 3.6% 2.9%
NPWT PUMP -21.0% -21.0% -17.8% -25.2% -20.6%
SUPPORT SURFACES (E0277) -23.7% -26.9% -22.7% -31.3% -25.5%
TOTAL AVERAGE REDUCTION -6.2% -8.0% -5.9% -8.8% -7.1%
 
Categories in the Round 2 Recompete that were not part of the original Round 2 bid cycle include: Nebulizers and Relations Supplies; TENS Devices and Supplies, Commodes; Urinals & Bed Pans; Patient Lifts; and Seat Lift Mechanisms.       

Reminder: In light of access problems with their Connexion site when bid results were first released, CMS has extended the period to respond to Round 2 Recompete contract offers to Thursday, March 31.                        
HME Audit Key
HME Audit Key 2nd Quarter Data Period Entry Opens April 15

Be a part of the data-driven campaign to advocate for much-needed improvements to the audit process and see how your company stacks up in terms of audit volumes and appeal overturn rates. 

Get ready to enter your First Quarter 2016 audit data starting on April 15.  If you didn't participate in the first data entry period (4Q 2015), you can still register and participate in this next round - visit HMEAuditKey.org to register and learn more.

Want to learn more?  You can find presentations here that show you how to get started and enter your data.  Results from the 4Q 2015 round will be available shortly.
Washington Legislative Conference
Join Your Peers at the Washington Legislative Conference to Fight for Better HME Policy

May 25-26, 2016
Washington Court Hotel - 1-800-321-3010 | 202-628-2100 - ask for American Association for Homecare rate or
reserve your room online, using promo code AAH0516 (0 = zero)
Single $299 | Double $319 -- rates guaranteed through Friday, May 6


Online conference registration available here - AAHomecare members $99 |  non-members $149
Downloadable form to register by mail or fax.

Member Benefit
Insurance Savings for AAHomecare Members

AAHomecare members are eligible to receive a 10 percent discount on surety bond premiums and comprehensive 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.

What's Happening
AAHomecare in Action...

Jay Witter, senior vice president of public policy, attended a reception for House Energy & Commerce Committee staff… the State Leaders Council and Complex Rehab & Mobility Council convened… 

Upcoming Webinars 

Aggressively Moving Into the Retail Market While
Avoiding Legal Pitfalls
Webinar presented by: Jeff Baird, Brown & Fortunato, P.C.
April 5, 2:30-4:00 p.m. EST


A DME supplier can no longer survive while being dependent on Medicare fee-for-service. With
competitive bidding, stringent documentation requirements, lower reimbursement, postpayment
audits, and the fact that Medicare is tightening its purse strings, Medicare fee-for-service should only be a component of the supplier’s total income stream. There are 78 million Baby Boomers (people born between 1946 and 1964); they are retiring at the rate of 10,000 per day. Boomers are accustomed to paying for things out-of-pocket.

The successful DME supplier will be focused on selling upgrades, utilizing ABNs, and selling items for cash. These retail sales may take place in a store setting, or they may take place over the internet. Even when Medicare is not the payor, there are a number of requirements that the DME supplier must meet.

This program will discuss the federal and state requirements that the DME supplier must meet as it sells DME at retail. These requirements include state licensure, collection and payment of sales and/or use tax, qualification as a “foreign” corporation, obtaining a physician prescription, and
complying with federal and state telemarketing rules. In addition, the program will discuss how the supplier can sell Medicare-covered items at a discount off the Medicare allowable.


Register today!
Price: Member: $99.00 | Non-Member: $129.00

 

AAHomecare Corporate Partners
 



            

         

        

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