WASHINGTON, DC – CMS announced it will be restarting audits from DME MAC, SMRC, and RAC again beginning August 3. Originally, CMS announced in March that reviews will be put on hold for the duration of the Public Health Emergency, but in the recent announcement, they affirmed state re-openings and the importance of program integrity as reasons to rescind the pause on the programs.
AAHomecare understands that this is incredibly troubling for suppliers. Many supplier locations are still short-staffed or closed and do not have the bandwidth to continue to provide services to patients and simultaneously respond to review requests. With news of states reopening and closing, and with the rise in case numbers, we do not believe this is the time to have normal audit operations. AAHomecare is working on this issue and will be sharing concerns with CMS.
You can find CMS’ announcement on audits restarting on August 3 in the Coronavirus Disease 2019 (COVID-19) Provider Burden Relief FAQs.
Policymakers Need to Understand the New Realities for HME in This Crisis
The COVID-19 pandemic is the most significant public health emergency in our lifetime. After an optimism-inducing decline in cases nationwide from mid-April through mid-June, the coronavirus is again spreading rapidly. And even in areas where the pandemic is comparatively under control, HME suppliers and other healthcare workers are still subject to regulations and operational protocols to protect the safety of patients and health professionals alike.
Ensuring that HHS, CMS, and Capitol Hill understand how moving forward with the next round of the Competitive Bidding Program in this environment will hinder our ability to support patients and reduce hospital burdens during the COVID-19 pandemic and its aftermath remains a priority for the HME industry.
If you haven’t already done so, please reach out to your Senators and Representative to ask that CMS delay Round 2021 of the Bidding Program for at least one year – and allow HME to make its strongest possible contribution to responding to this healthcare crisis.
Under the current operating environment on Capitol Hill, the most effective form of contact is to send a personal email to the legislative staffer who handles healthcare issues for your Senators or Representative.
Your letter should include:
- A brief description of your company, the services you provide, and a list of the cities, areas, or communities you serve.
- How the COVID-19 pandemic has added increased equipment, staffing, or operational costs (including personal protective equipment costs) and otherwise impacted your ability to serve patients – as well as lost revenue related to the crisis. You do not need to be exhaustive in your details; focus on a few of the most important cost increases or operational challenges.
- Note that Round 2021 of the Medicare Competitive Bidding Program relies on bids that were developed and submitted well before the COVID-19 pandemic. As a result, these bids do not take into account supply chain disruptions, new safety/operational requirements, and higher costs that your company has incurred under the public health emergency. Put simply: bids HME companies submitted in the Fall of 2019 for the next bidding round will not reflect new realities for the healthcare industry in 2021 and beyond.
- Conclude by encouraging your legislator to contact CMS and ask for a pause of the Bidding Program for at least one year to allow your company to continue to provide a high level of care during the COVID-19 pandemic and in its aftermath, and to support legislation to delay the Bidding Program should CMS fail to do so.
You can contact Gordon Barnes at firstname.lastname@example.org for assistance in crafting your messages or finding contact information for your legislators.
You can also use these materials in developing your outreach to Capitol Hill:
- Issue Brief: Congressional Action Needed to Delay Competitive Bidding Program for Durable Medical Equipment
- Talking Points: Competitive Bidding Round 2021 and COVID-19
- Encourage your colleagues, friends, and other contacts to use our Action Center to send an email to Capitol Hill in support of delaying Round 2021. Users can edit the draft letter provided to include their own perspectives and experiences.
The HME industry needs to focus on maintaining and building capacity as the pandemic continues to threaten vulnerable patient populations and disrupt businesses, schools, and communities across the nation. Please reach out to your Senators and Representative and ask for their support in making sure that HME suppliers are equipped to meet the challenge ahead.