WASHINGTON, D.C. – As AAHomecare recently shared, Sen. John Thune (R-S.D.) [pictured] and Sen. Debbie Stabenow (D-Mich.) have introduced S.1294, legislation to further extend the Medicare 75/25 blended rate for non-rural, non-CBA suppliers through the end of 2024.

S. 1294 extends relief granted in the 2022 Omnibus budget legislation keeping 75/25 rates for an additional year and provides more stability for suppliers in these areas.  The bill would also impact rates from other payers who are influenced by Medicare rates, including TRICARE and Medicaid programs in more than 20 states.

HME advocates can help build support by contacting their Senators to ask that they sign on as a co-sponsor for S. 1294.  An email or call to the staffer who handles healthcare issues for your Senator is the most effective way to make a strong impression.

Messaging tips:

• Briefly mention where your company is located, what you provide, and how those products/services support the patient cohort you serve.
• Challenges your company is facing with rising costs for products, labor, shipping/delivery, and other operational requirements vs. current reimbursement rates.
• Concerns about your continued ability to serve patients in your community under current reimbursement rates that don’t reflect market reality.
• Ask your Senator to co-sponsor S. 1294:
  • Introduced by Senators John Thune (R-SD) and Debbie Stabenow (D-MI)
  • Extends the 75/25 blended rate for non-bid, non-rural relief included in the 2022 Omnibus legislation by one year (until the end of 2024)

See AAHomecare’s Issue Brief for additional background on the need for this legislation. Please contact Gordon Barnes at [email protected] for contact info for Senate healthcare staff.

You can also ask colleagues to send a message to their Senators using our Voter Voice advocacy system. A pre-drafted message is included; users are encouraged to add their own perspectives and experiences.

Additional AAHomecare In Action Events

WASHINGTON, D.C. – Strategic Priorities Survey Now Open: AAHomecare is seeking input from all segments of the HME community to underpin a strategic planning process to guide the Association over the next 2-3 years. Make sure your company’s needs, and those of your patients or customers, are considered in that effort by taking the brief survey here.  Survey closes May 12; See related alert for more details

Alexis Ward to Join Payer Relations Team
AAHomecare is bolstering its advocacy capabilities in critical areas through the addition of Alexis Ward as Senior Director of Payer Relations, effective June 19, 2023. Ward brings a wealth of in rate negotiation, coverage policies, compliance issues, and clinical review, with particular expertise in expanding coverage of and payment for CRT products.  Read more in yesterday’s Alert.

CMS Shares Post-PHE FAQ
CMS published the much-anticipated Frequently Asked Questions: CMS Waivers, Flexibilities, and the End of the COVID-19 Public Health Emergency.  AAHomecare excerpted answers for questions related to DME supplies and continuous glucose monitors in our Apr. 27 Alert.

CMS Addresses Post-PHE CR Modifier Concerns
DME MACs published new post-PHE directions for DME suppliers stating that for claims impacted by the COVID-19 PHE, the CR modifier and COVID-19 narrative can be continued to be used for ongoing rental and supplies/accessories after the end of the PHE on May 11th. New guidance comes after AAHomecare and DME MAC Advisory Councils raised concerns with an earlier decision to remove the CR modifier.  See Apr. 28 alert for more.