WASHINGTON, D.C. – AAHomecare joined 27 other state, regional, and national HME organizations in a letter thanking Reps. Mariannette Miller-Meeks (R-IA) and Paul Tonko (D-NY) for introducing H.R. 5555 and reinforcing the commitment to working with legislators to pass the bill.

The letter focuses on the widening disconnect between current reimbursement rates and product/operational costs facing suppliers in making the case for extending 75/25 blended rate relief in non-rural/non-CB areas.

AAHomecare and its lobbying team continue to meet with champions on Capitol Hill and key legislators to build support and position H.R. 5555 provisions for inclusion in healthcare or omnibus legislative packages expected later this year. New co-sponsors for the legislation are still being added; Rep. Andre Carson (R-IN) became the latest to sign on to the bill.

See the full letter here.  Additional messaging and advocacy resources on extending 75/25 blended rate relief can be found here.

ALS Patients Get An Advocacy Boost

WASHINGTON, D.C. – Living with ALS, a new report from the National Academies of Sciences, Engineering, and Medicine on improving the quality of care for individuals with ALS, includes specific recommendations to strengthen access to respiratory care.

A policy brief accompanying the report urges CMS and private insurers to act quickly to expedite access to essential ALS medical and support services, including:

• Requiring expedited (within 72 hours) responses to prior authorization requests for all therapies, durable medical equipment, assistive technologies, and services for persons with ALS.
• Not denying services for persons with ALS based on failure to show functional improvement, given the progressive nature of the illness.

The committee producing the report notes that significant barriers remain to delivering optimal clinical respiratory care, despite evidence that high-quality respiratory management bolsters survival rates and improves quality of life. Accordingly, they recommend that:

CMS and private insurers should immediately align coverage of respiratory devices and services for persons with ALS with the current standard of care. CMS and private insurers should also develop reimbursement models that allow respiratory professionals to provide high-quality, longitudinal respiratory care in the home of a person with ALS.

The findings and recommendations related to respiratory care in the report echo messages that our partners in the clinician community and at the ALS Association have been making to remove barriers to access for non-invasive ventilators (NIV) for patients with severe respiratory challenges.  The new report will lend additional credibility to our ongoing advocacy to ensure these individuals and their caregivers can benefit from these life-sustaining products.

• Consensus Study Report Policy Brief
• Respiratory Management of ALS report sub-section(see page 69 if the link does not take you there directly)
• Living with ALS– full 191-page report available for download.