The Council for Quality Respiratory Care (CQRC) commended lawmakers in the House Ways & Means Health Subcommittee for reviewing legislation to sustain and improve the Medicare program, including Patient Access to Durable Medical Equipment Act (PADME).
The PADME Act – bipartisan legislation widely supported by the respiratory care community – will extend the implementation of severe Medicare cuts to durable medical equipment (DME).
The PADME Act delays cuts to home oxygen supplies and services that began on January 1, and are scheduled for full implementation on July 1. The cuts are the result of the Centers for Medicare & Medicaid Services (CMS) applying 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 warns that more time is needed to observe and analyze the impact of the cuts on beneficiary access before additional cuts take effect. While home oxygen leaders caution cuts could put access to high-quality and innovative home respiratory therapy at risk, they also warn cuts could result in higher overall Medicare spending due to increased hospital admissions.
“In many parts of the country, the amount paid for these services doesn’t cover the cost so it could decrease availability,” said Congressman Tom Price, MD at today’s hearing when addressing the PADME Act – referencing a 20 percent decrease in the number of DME providers in his home state of Georgia.
Home oxygen leaders stress the importance of consistent and uninterrupted access to home respiratory care — particularly for patients managing COPD, who are vulnerable to hospitalizations and readmissions and reside heavily in rural areas.
Specifically, the bill would:
- Extend the current phase-in of the blended rate (50 percent of the previous fee schedule rate and 50 percent 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 the 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.