According to a press release from The Council for Quality Respiratory Care (CQRC), the US Senate has passed the Patient Access to Durable Medical Equipment (PADME) Act (S.2736). The bill would phase-in deep Medicare cuts to home respiratory care supplies and services to ensure patient access to care is not placed at risk, CQRC reported.
A companion bill, HR 5210, is under consideration in the US House of Representatives.
“We applaud the U.S. Senate for recognizing the urgency in passing this legislation before July 1, which will help to ensure that patient care is not jeopardized as a result of these Medicare cuts, and strongly urge their colleagues in the House to do the same,” said Dan Starck, Chairman of CQRC. “By extending the phase in of these cuts, the policy-making and provider communities can more full assess how reimbursement reductions impact both patient access and quality of services. We continue to have significant concerns with the established competitive bid rates and their application to patients nationwide.”
The Senate bill 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 percent of the previous fee schedule rate and 50 percent of the new competitively bid-based rate) until July 1, 2017, which delays additional cuts in rural areas by 12 months.
- Adjust the bid ceiling on competitive bidding submissions by ensuring that this ceiling never drops below the rates in place on July 1, 2016.
- Require publication of a quarterly report by CMS to monitor the impact of the cuts on Medicare beneficiary access beginning on October 1, 2016.
- 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.
Other industry leaders have expressed serious reservations with the application of competitive bid rates to other non-competitive bid areas that Congress specifically excluded from the DME competitive program, underscoring the importance of enacting this legislation in advance of the July 1 deadline. The CQRC reported the following statements from industry leaders:
COPD Foundation: “With the roll out of competitive bidding nationwide, oxygen access has become less certain for COPD patients. The more portable and lighter, liquid oxygen is no longer available from many DME companies and choice and delivery options are being cut, leaving patients to scramble to keep up with the changes… The COPD Foundation is also pleased that H.R. 5210 includes patient-centered requirements like requiring CMS to further engage stakeholders to track and publicly post complaints and outcomes. Many of these provisions are especially vital to rural providers who have struggled to remain competitive with rates being set by larger, more urban providers.”
National Association for Medical Direction of Respiratory Care: “We believe this legislation is a reasonable approach to address a complex set of issues, particularly given the lack of evidence that competitive bidding has not negatively affected beneficiary access to care. As physicians providing pulmonary care to some of the most vulnerable Medicare patients, NAMDRC supports this bill and asks the committee to move expeditiously to pass it.”
Healthcare stakeholders, including Advanced Medical Technology Association: “Durable medical equipment is vital to maintaining and improving the health and quality of life for millions of Medicare patients needing these products in their homes. Losing access to these crucial technologies, as well as access to high quality and physician prescribed products, due to severe cuts to DME payment rates will compromise patient health. We urge you to take up and pass legislation that will protect patient access to needed durable medical equipment.”
Home respiratory therapy supplies and services are vital to managing COPD and other pulmonary conditions. Data show home oxygen care reduces preventable hospitalizations and readmissions, signally that reduced access to quality respiratory care in the home will result in increased emergency room (ER) visits and readmissions, therefore harming patient outcomes and increasing Medicare costs.
“With the full DME cuts scheduled to take effect in just two weeks, the Congress must act now to ensure this bill is signed into law. By doing so, our federal lawmakers will allow more time for our community to examine these cuts to ensure access to the quality services our sick, elderly patients need,” added Starck.