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PAMES could not support its goals in advocating for the interests of our industry without your contributions. Please take a moment to review the different contribution levels below and consider participating. We greatly appreciate your financial support of our legislative efforts.
FUND CONTRIBUTION LEVELS
||$5,000 & up
All Legislative Fund Contributors will be listed on the PAMES’ Legislative Page. Level assignments are good for one year from the date the application is received (an application must be received for all levels and amounts are considered payable in full for the entire year). No refunds are given for partial use and/or cancellation of program(s).
|Significant DMEPOS Provisions Included in Just-Released ESRD Rule
|Late this afternoon, CMS released updated guidance on a proposed rule that proposes to update payment policies and rates under the End-Stage Renal Disease (ESRD) payment system that also includes major new provisions related to DMEPOS competitive bidding and the current fee schedule. According to CMS provisions of the new rule include:
- Beginning January 1, 2019 beneficiaries may receive DMEPOS items from any Medicare enrolled DMEPOS supplier until new contracts are awarded under the next round of the bidding program.
- CBA pricing will be subject to annual CPI adjustments until the next bidding round takes place.
- Implements lead item pricing for future competitive bidding rounds.
- Revises the definition of composite bid to mean the bid submitted by the supplier for the lead item in the product category.
- Establishes a new method for establishing SPAs under the CBP using maximum winning bids.
- Extends the 50/50 blended rate reimbursement rates for rural and non-contiguous areas (i.e., Alaska & Hawaii) provided in the recent IFR through December 31, 2020.
- CMS requests additional comments on whether the 50/50 blended rates should be extended to other non-bid areas and will continue to monitor healthcare outcomes and information for future ratemaking.
The CMS Fact Sheet does not set a specific timetable for the next bidding round.
- Establishes a new methodology for ensuring that all new payment classes for oxygen and oxygen equipment added since 2006 are budget neutral.
DME Suppliers host key meetings with Energy and Commerce committee members Cathy McMorris-Rodgers (WA) and Larry Bucshon (IN)
Peaks & Plains Medical hosted a wonderful event with Congresswoman Cathy McMorris-Rodgers at their Spokane, Washington office. Yesterday, over a dozen providers across the state were able to attend which was a strong showing of support
to direct towards the Congresswoman. With this support Rep. McMorris-Rodgers took great interest in signing on to the H.R. 3229 CRT bill, which will exclude CRT accessory items from competitive bidding. A big shout-out to those in
attendance for showing just how important these issues are to the industry!
Vice President of Peaks & Plains, Leigh McNellis, reports back that the Congresswoman was very supportive about the issues that providers had brought to her. “Washington Providers were given a renewed sense of hope to have Congresswoman Cathy McMorris-Rodgers’ support on keeping access to medical equipment and supplies to rural Washington clients with an engaging discussion of the issues at hand,” said McNellis.
HME in DC: Rep. Ellmers Fights for HME Providers on Capitol Hill
Reprinted from American Association for Home Care
Homecare champion Rep. Renee Ellmers (R-NC) today presented a series of questions about DME audits at a hearing before the House Energy and Commerce Subcommittee on Oversight and Investigations entitled “Medicare Program Integrity: Screening Out Errors, Fraud, and Abuse."
Ellmers presented problems that providers face with audits and the timetable for payment to Deputy Administrator and Director at the Center for Program Integrity at CMS, Shantanu Agrawal, M.D., and showed how difficult it is for providers to stay in business with the excessive audit demands they face - up to 46 percent of claims in some categories.
“There is fraud, we all know that there is fraud and abuse of the system, but you are going after the good guys to make up the dollar difference. You are not addressing the real fraud issues," said Ellmers during her questioning.
Rep. Ellmers has been an advocate for the HME industry, thanks to hard work from NCAMES and HME providers in North Carolina. These members built a relationship with Rep. Ellmers and educated her on the issues such as competitive bidding and the out of control audit system that hurt businesses.
A video of the exchange is available on the Energy and Commerce Subcommittee YouTube page. Click here to view the video of Rep. Ellmers.
Take Action on Binding Bids Legislation
Reprinted from American Association for Home Care
Thanks to the combined efforts of HME advocates at the recent Washington Legislative Conference, as well as dedicated efforts by industry leaders, Reps. Pat Tiberi (R-Ohio) and John Larson (D-Conn.), have introduced H.R. 4920, the Medicare DMEPOS Competitive Bidding Improvement Act of 2014, legislation that makes all bids binding as well as requiring providers to obtain bonds and provide proof of licensure before bidding.
Stakeholders and economists have repeatedly cited the use of speculative, non-binding bids as a major flaw in the bidding program that is causing havoc for patients and providers nationwide. This fix to the bidding program will make all bids binding as well as require providers to obtain bonds before bidding, cut low-ball bids out of the system and ensure that there are enough legitimate bid winners available to serve patients who need home medical equipment.
Given the compressed election-year calendar that remains for this Congressional session, we need your help to quickly build support for this important legislation. There are a number of ways you can contribute to the success of this bill. Send an email in support of H.R. 4920 to your Representative here, and find additional resources for contacting Capitol Hill here on our H.R. 4920 Take Action page.
We need a concerted and passionate response from all segments of the homecare community to convince Congress to take action and provide this important fix to the bidding program.