November 28, 2016

Suppliers Praise Cures Bill Provisions to Ease Medicare Bid Cuts

Bloomberg BNA!/articles/OHDJ173H0JK0

Suppliers Praise Cures Bill Provisions to Ease Medicare Bid Cuts

Nov. 28 (BNA) -- Provisions in the 21st Century Cures Act that would ease cuts in Medicare reimbursement rates for durable medical equipment were applauded Nov. 28 by groups representing suppliers.

“This is a very positive step,” the Council for Quality Respiratory Care, which represents home oxygen therapy provider and manufacturing companies, said in a Nov. 28 statement.

The House is expected to vote as soon as Nov. 30 on the Cures legislative package, which includes some Medicare provisions.

Durable medical equipment companies have opposed competitive bidding, which was required under the Medicare Improvements for Patients and Providers Act of 2008, saying lower rates have led to beneficiary access problems as suppliers have been driven out of business.

Six-Month Rollback

One section in the package would roll back lower payment rates for durable medical equipment that were based on competitive bidding.

The rates, which imposed payment levels derived from competitive bidding in areas in the country where bidding has not taken place, were implemented in two phases. The second phase, which went into effect July 1, would instead begin on Jan. 1, 2017, under the Cures legislation.

The impact of applying competitive rates to noncompetitive bid areas “equals a cut of up to 50 percent,” the respiratory council said.

The delay would allow suppliers to recoup the reductions they experienced for items that were purchased for beneficiaries during the second half of 2016, the American Association for Homecare said in a statement.

Full-Year Delay Preferred

The association is happy the six-month delay was included as a “first step” toward helping suppliers stay in business, Tom Ryan, AAHomecare president and CEO, told Bloomberg BNA.

However, the association would have liked a full-year rollback. The cuts will return on Jan. 1, 2017, Ryan said.

“I look at it as a touchdown for us, but we haven't won the game yet,” he said.

Travel Time Considered

The legislation also would require that the Medicare agency take into account suppliers’ average travel time when determining adjustments to DME reimbursements.

“I think it's terrific that there's going to be some measurable metrics they have to look at,” Ryan said.

The application of competitive bidding derived rate cuts on accessories used with certain complex wheelchairs also was delayed or six months. The rates for these accessories would now go into effect on July 1, 2017.

However, the legislation also would speed up plans to limit state Medicaid reimbursement amounts to Medicare rates, including those derived from competitive bidding. The provision would take place on Jan. 1, 2018, instead of Jan. 1, 2019.

The association isn't happy with that but understands the provision is likely being used to pay for the six-month delay and other measures in the package, Ryan said.

To learn more, visit and follow CQRC on Twitter at @TheCQRC.

Click here to see the original article on the Real Clear Health website.

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