HNC Statement on Protecting HOME Access Act
The Healthcare Nutrition Council (HNC) is pleased to support the Protecting Home Oxygen Medical Equipment (HOME) Access Act of 2017 (H.R. 4229). This bipartisan legislation is needed to offer sustainable access to quality Durable Medical Equipment (DME), particularly for those individuals in rural areas. HNC represents the manufacturers of enteral nutrition formulas, parenteral nutrition solutions, supplies and equipment for patients in all healthcare settings, including home healthcare settings. One key provision of H.R. 4229 is the relief it would provide to DME suppliers from competitive bidding by rolling back the second round of Medicare cuts for non-bid area suppliers. This will ensure individuals who depend on life saving home therapy, like home infusion therapy, have access to the supplies that are vital to delivering parenteral and enteral nutrition therapies covered under the Medicare Part B Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) program.
Over the past few years, Centers for Medicare and Medicaid Services (CMS) has made significant policy and regulatory changes that have resulted in reductions in reimbursement for DMEPOS for Medicare beneficiaries. Both infusion pumps and enteral nutrition product categories were impacted by a 2014 CMS rule establishing the methodology for making national price adjustments to the fee-for-service payments. The first phase of a two-part phase-in for reimbursement adjustments began on January 1, 2016, which applies pricing derived from highly populated Competitive Bidding Areas (CBA) to all areas of the country. This included rural areas, or non-CBAs, where the cost of supplying DMEPOS items is higher. For six months, reimbursement rates were 50% of the un-adjusted fee schedule and 50% of the regional single price amount (RSPA), or a blended reimbursement rate. Six months later on July 1, 2016, the blended reimbursement rate phased out and reimbursement was now based 100% off of the regional single price amount. This slashed Medicare reimbursement by over 50% on average. According to a recent survey of Medicare beneficiaries, case managers, and home medical equipment providers, three quarters of those interviewed reported a disruption in their ability to receive home medical equipment since July 2016 when these reimbursement cuts went into effect.
Although Congress acted last December by extending the blended reimbursement rates through December 31, 2016 by passing the 21st Century CURES Act, on January 1, 2017 the full reimbursement cuts from July 1, 2016 went into effect again. The passage of H.R. 4229 is critical to ensure those with disabilities or chronic conditions have the lifesaving equipment they need by extending the blended reimbursement rate from January 1, 2016 rate to remain in effect through December 31, 2018. In rural areas, many individuals experience little to no access to the specialized nutrition formulas, equipment and supplies they need. This can lead to many adverse health consequences like malnutrition, nutrient deficiencies, hospitalization, medical complications, comorbidities, or even death, all costly to the patients and the healthcare system.
H.R. 4229 was introduced in the U.S. House of Representatives by Representatives Cathy McMorris Rodgers (R-WA) and David Loebsack (D-IA), along with 53 original co-sponsors. HNC joins the American Association for Homecare, the National Home Infusion Association and many other healthcare organizations in supporting H.R. 4229 and urging for the bill’s immediate passage. H.R. 4229 is just the first step to ensuring that DMEPOS, specifically parenteral and enteral nutrition therapy, supplies and equipment, are more accessible to Medicare beneficiaries. We look forward to working with Members of Congress to expand upon Representatives McMorris Rodgers and Loebsack’s reimbursement relief efforts.