Observation Deck

It’s Time to Go ‘All In’ on HME Advocacy

Make your voice heard on Medicare reimbursement policy by joining the Virtual 2022 Washington Legislative Conference on Sept. 21.

• By Tom Ryan
• Aug 02, 2022

Since the onset of 2020, our country has seen the sharpest inflation spike since the early 1980s and the deadliest pandemic in history. While these twin challenges have impacted almost every part of everyday life, I remain confident in our nation’s collective ability to weather these storms and continue to move forward.

The Covid-19 pandemic also tested our healthcare continuum — and the home medical equipment sector — in ways most of us would have never imagined. HME suppliers and other industry stakeholders can be proud of how we’ve met the moment in supporting our patients and helping reduce the demands on hospitals and nursing facilities through home-based care. We have a long track record of rising to the occasion during severe weather and disasters, but this long-term crisis has shined a bright light on this industry’s exceptional commitment and capability.

While the value of quality HME and experienced homecare professionals has never been more evident, our industry remains hamstrung by a reimbursement structure that has been panned by providers, economists, and other stakeholders for more than a decade. CMS and the Medicare bidding program for HME have failed to produce reimbursements that reflect market reality, and as a result, we’ve seen nearly one-third of HME locations close their doors or leave the Medicare market since 2013. The current reimbursement structure for HME’s bellwether payer must change — and we need everyone on board for our strongest push ever to secure meaningful, long-term relief.

We Can’t Miss This Opportunity

HME rates have remained substantially unchanged since 2016 except for CPI adjustments that don’t come close to covering higher product prices, shipping surcharges, spiraling fuel prices (currently nearly double the average for the previous five years), and new operational costs associated with keeping patients and staff safe during the pandemic.

AAHomecare and HME leaders have been making a case for long-term relief for suppliers in Medicare CBAs, as well as for rural and non-rural/non-CBA suppliers. While the process might seem slow and frustrating at times, these efforts have ultimately resulted in securing 50/50 blended rates for suppliers until the next bidding round (whenever that might be), and 75/25 blended rates for non-rural, non-CBA suppliers until the formal end of the COVID-19 Public Health Emergency.

Those measures of relief have ended up putting more than $3.3 billion in suppliers’ pockets over the last six years. None of that relief would have taken place without the persistent advocacy efforts that have helped build our industry’s credibility on Capitol Hill. These successes prove we can move the needle on Medicare reimbursement policy through smart, focused lobbying and engaged grassroots efforts.

We can’t miss the opportunity to build on these successes and secure broader and more substantial relief for HME. Earlier this year, we worked with Reps. Markwayne Mullin (R-Okla.) and Paul Tonko (D-N.Y.) to introduce H.R. 6641, legislation to apply a 90/10 blended rate for Medicare in CBAs, applicable to reimbursements from the beginning of 2022 through December 2023. A 90/10 blended rate would provide an average 9 percent boost for items covered under the bidding program, helping HME suppliers keep pace with rising costs. At the same time, we’re also working to build support for extending relief for rural and other non-CBA suppliers in the Senate.

We have legislation teed up in the House, we have a great story to tell about HME’s proven value, and we have a wealth of data on how rising costs are changing the business environment for suppliers. Now we need to put it all together with a strong advocacy effort this Fall — and we need everyone on board.

Critical Period to Engage Capitol Hill

Congress will return from its August recess for what is certain to be a busy four weeks before adjourning again at the end of September. In that stretch, we must make one more concerted push on 90/10 blended rates, and we need you to take action this September.

One way you can make your voice heard is by taking part in AAHomecare’s Virtual 2022 Washington Legislative Conference, set for Wed., Sept. 21. You’ll join with your fellow HME advocates in Zoom-enabled meetings with members of Congress and healthcare staffers to make a case for H.R 6641 and other policy priorities, including:

• Extending Medicare rate relief for suppliers in rural/non-bid areas.

• Reforming competitive bidding policies that allow CMS able to reject bidding results at its sole discretion.

• Protecting access to respiratory therapy and continuous glucose monitors after the end of the COVID-19 PHE.

• Preventing potential 4 percent Medicare sequester cuts in 2023 triggered by the application of 2010 Pay-As-You-Go (PAYGO) legislation to COVID-19 relief deficit spending.

• Ensuring that members of Congress understand how rising product and operational costs, as well as supply chain issues, are impacting HME providers and patients.

We will set up your meetings and provide the virtual platform, along with issue education, talking points, and other guidance to help you make a strong impression on your Senators and Representatives.

This year’s conference is perfectly timed to make a maximum impact, coming just before a Sept. 30 deadline to pass government funding legislation, as well as to help influence potential omnibus legislation later in the year. Whether you’re a veteran HME advocate or new to lobbying your legislators, this conference is your opportunity to help improve the business and regulatory environment for our industry. Learn more at aahomecare.org/WLC. Registration closes on Sept. 14.

This article originally appeared in the Jul/Aug 2022 issue of HME Business.