The Council for Quality Respiratory Care (CQRC) has commended Representatives Tom Price (R-GA), Dave Loebsack (D-IA), Cathy McMorris-Rodgers (R-WA) and Peter Welch (D-VT) for introducing the Patient Access to Durable Medical Equipment Act (PADME), according to an agency press release. The legislation will protect patient access to respiratory care therapies by extending the implementation of severe Medicare cuts to durable medical equipment.
“We strongly support the introduction of this legislation in the US House and look forward to working with Congressman Price and his bipartisan colleagues to see this bill signed into law before July 1 to protect access to respiratory care for the vulnerable, elderly patients our members serve,” Dan Starck, Chairman of CQRC, said in a release. “This bill provides policy-makers with the time they need to assess the impact of the cut on the care being provided to patients and evaluate whether the additional cut should also be applied.”
In addition to supplying equipment, oxygen, and supplies, home respiratory therapy providers provide patient-centered services to reduce hospitalizations. Working with hospitals and commercial payors, CQRC companies have developed and implemented programs to help reduce hospitalizations and Medicare program expenditures. Managed care programs and commercial payers already recognize the important role home respiratory therapy plays in reducing overall health care spending.
Despite the critical role home respiratory therapy providers play in managing COPD and reducing preventable hospitalizations and readmissions, they received the first set of dramatic cuts to Medicare respiratory therapy on January 1, CQRC said. These cuts were the result of the Centers for Medicare & Medicaid Services (CMS) applying the competitive bid rates used in urban areas to rural and other non-competitive bid areas that Congress specifically excluded from the DME competitive program. The CQRC is deeply concerned that these cuts puts senior access to high-quality and innovative home respiratory care at extreme risk. Further, CMS provided an accelerated six-month phase-in for the cuts, leaving little time for the Agency to assess the impact of the initial cut before implementing the second half of it.
The legislation provides relief to home respiratory therapy providers in non-competitively bid areas by allowing additional time for the implementation of the rate cuts. Specifically, the bill would:
- Extend the current phase-in of the blended rate (50% of the previous fee schedule rate and 50% of the new competitively bid-based rate) until October 1, 2017, which delays additional cuts in rural areas by 15 months.
- Adjust the bid ceiling on competitive bidding by setting ceiling at the FY2015 fee schedule rate and adjust for inflation to create a measure of stability in the competitive bidding program.
- Require publication of a monthly report by CMS to monitor the impact of the cuts on Medicare beneficiary access.
- Require CMS to take into account specific factors when adjusting the noncompetitive bid rates to ensure that the rates take into account unique aspects of providing services in rural and other nonurban areas.