WASHINGTON—Congresswoman Vicky Hartzler (R-Mo.) this week voted to pass the Patient Access to Durable Medical Equipment (PADME) Act, a bipartisan solution that would preserve patient access to durable medical equipment (DME). The Hartzler co-sponsored bill passed the House on a voice vote.
“Where one lives should not adversely affect one’s access to affordable medical equipment such as wheel chairs, oxygen tanks, blood sugar monitors, and other lifesaving equipment,” Hartzler said. “Missouri’s seniors every day rely on this equipment for their health and wellbeing. This bill aims to make sure equipment providers can continue to serve the rural and most affected populations so they can continue to receive the quality care they deserve.”
By preventing severe cuts to Medicare DME reimbursement rates, the Hartzler co-sponsored legislation will ensure that DME providers are able to continue to meet the needs of Medicare patients and ensure that beneficiaries have access to quality items and services in all parts of the country. Examples of DME include blood sugar monitors, canes, crutches, hospital beds, power wheel chairs, and oxygen tanks.
Congresswoman Hartzler represents Missouri’s Fourth Congressional District in the U.S. House of Representatives. She serves on the House Agriculture, Armed Services, and Budget Committees.
The Competitive Bidding Program (CBP) was created by the Medicare Modernization Act of 2003. The Congressional objective in requiring Medicare to use competitive bidding to establish payment amounts for DME was intended to reduce Medicare and beneficiary expenditures and ensure that beneficiaries have access to quality items and services. The CBP has failed patients, though, because it does not hold bidders accountable, does not ensure that bidders are qualified to provide the products in the bid markets, and produces bid rates that are financially unsustainable. More than 240 market auction experts and economists have warned that the Medicare competitive bidding program is unsustainable in its current form.
In January 2016, the competitive bidding program for DME began its nationwide rollout. As a result, many areas, including rural areas, saw significant cuts, jeopardizing access to DME for beneficiaries. For many rural providers, these new rates will not even cover the cost of delivery for the item.
An extension of the current DME rate is necessary to avert deep cuts in reimbursement following the rollout of Medicare’s competitive bid pricing into non-competitively bid areas.
The legislation approved by the House of Representatives today amends H.R. 5210, the Patient Access to Durable Medical Equipment Act, to provide a three month delay of the July 1st cuts to DME reimbursement rates in non-competitively bid areas. Additionally, it:
- Requires the Department of Health and Human Services (HHS) to conduct a DME study over the course of the three months to identify issues related to patient access to DME.
- Includes H.R. 3716, the Ensuring Access to Quality Medicaid Providers Act, introduced by Rep. Larry Bucshon, M.D. (R-Ind.), which already passed the House unanimously by a vote of 406-0 on March 2nd and which requires states to report to the Centers for Medicare and Medicaid Services (CMS) within 21 business days any medical providers that have been terminated from participating in their Medicaid and Children’s Health Insurance Program (CHIP); requires providers serving Medicaid beneficiaries to be enrolled with their state’s Medicaid agency; and requires CMS to recoup the federal portion of Medicaid/CHIP payments made to providers for services performed more than 60 days after the provider’s termination was included in the CMS Termination Notification Database.
- Includes H.R. 3821, the Medicaid Directory of Caregivers Act, introduced by Rep. Chris Collins (R-N.Y.), which requires states to publish Medicaid provider directories.
- Includes H.R. 2949, the Treatment of Certain Payments in Eugenics Compensation Act, introduced by Rep. Patrick McHenry (R-N.C.), which states that payments made under a state eugenics compensation program cannot be considered as income in determining eligibility for, or the amount of, any federal public benefit. S. 1698 – a Senate companion bill to the McHenry legislation introduced by Sen. Thom Tillis (R-N.C.) – was passed by the Senate with unanimous consent in November 2015.