Washington, DC, March 23, 2018 --(PR.com
)-- The Council for Quality Respiratory Care (CQRC) – a coalition of the nation’s leading home oxygen therapy provider and manufacturing companies – today commended lawmakers in Congress for indicating that the Centers for Medicare & Medicaid Services (CMS) should release the Interim Final Rule (IFR) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) in the two-year spending omnibus released yesterday.
The legislation would ensure that the blended rate for home respiratory care is extended to lessen the draconian cut that results from the application of urban competitive bidding rates to non-competitive bid areas. Commended by the CQRC as an important first step, the home respiratory care community continues to work toward comprehensive reforms to the method by which rates are set under the competitive bidding program to stabilize the benefit for Medicare beneficiaries living with Chronic Obstructive Pulmonary Disease (COPD) and other respiratory illness.
“We applaud Congress for recognizing the need to release the Interim Final Rule for home respiratory care and urge CMS to act promptly to issue the IFR when the bill is signed into law. While this measure will provide some clarity to our sector on immediate Medicare payment, this is only a short-term solution,” said Dan Starck, Chairman of the CQRC. “We need to advance reforms to create a true market-based competitive bidding program that protects patient access to quality respiratory care in the home, which the current program puts at risk.”
The CQRC is advocating for critical reforms to the competitive bidding program (CBP), which currently uses a methodology to set the payment rates that artificially lowers payment for home respiratory supplies and services. As a result, rates are so low that providers cannot recover the full expense of providing services to patients across the country. The ability of home respiratory care providers and suppliers to absorb these below cost rates is no longer sustainable, underscoring the urgent need for more comprehensive reforms.
Specifically, the CQRC is advocating for reforms to the competitive bidding program that:
· Change the method for setting the Single Payment Amount from the median to clearing price (the amount of all the bids when arrayed that gets to the capacity level needed for the individual competitive bidding area (CBA)). This means no supplier is asked to accept a contract at a rate that is below what they bid.
· Ensure providers bid using a lead product (with the relationship among products determined by updated 2015 Fee Schedule as is done with the current inversion policy) or by simply bidding a percentage off of the 2015 fee schedule as annually update.
· Prohibit suppliers from using the bid amounts from suppliers with no historic volume of services (capacity) in the CBA. These suppliers can still win a contract if their bid is at or below the clearing price, but their lack of experience would not negatively impact the rates.
· Split oxygen and sleep equipment and supplies into two categories. These are very different products with different suppliers so including them in the same category skews the rates inappropriately.
Home respiratory therapy supplies and services are vital to managing COPD and other pulmonary conditions. Data shows home oxygen care reduces preventable hospitalizations and readmissions, signaling that reduced access to quality respiratory care in the home will result in increased emergency room (ER) visits and readmissions, therefore harming patient outcomes and increasing Medicare costs.
The CQRC is a coalition of the nation’s seven leading home oxygen therapy provider and manufacturing companies. Together, we provide in-home patient services and respiratory equipment to more than 600,000 (the majority) of the more than one million Medicare beneficiaries who rely upon home oxygen therapy to maintain their independence and enhance their quality of life. To learn more, visit cqrc.org and follow CQRC on Twitter at @TheCQRC.