Everything You Need to Know About the Competitive Bidding Rural Rollout

Posted on in HME Government Issues

RuralRollout The VGM Group is diligently working on your behalf to understand and combat the Competitive Bidding Rural Rollout, set to be enacted on Jan. 1, 2016. The competitive bidding program is poised to devastate rural health care as we know it with the rollout of CB rates throughout the United States. The Need to Mitigate the Rural Rollout The VGM Government Relations team is working on solutions to the competitive bidding program from multiple angles. We are seeing a more engaged Congress, aware of the harm this program will have on the DMEPOS industry and the beneficiaries we serve. The current focus is to phase in the nationwide rollout over a four-year period instead of current statute of a five-month phase-in. Instead of a 10 percent add-on for certain rural areas as planned by CMS, implement a 30 percent add-on for all areas outside a CBA. Also included in this effort is the need to eliminate the bid limit cap. This, while being a short term effort, will impact all future bids/re-bids and help providers in and outside CBAs. Mitigating this rollout of bid rates to rural America is key to allowing for the long-term fix to replace competitive bidding entirely with the Market Pricing Program. Representative Tom Price of Georgia, our industry champion, continues to work on the mitigation of the rural rollout. He is currently in communications with Senator John Thune of South Dakota to bring the issue to the Senate side. Friends in High Places Meetings with the Small Business Administration in multiple locations, including Iowa, Washington, Montana and Washington, D.C. have earned us support from the agency. At the recent meeting in Montana, Brian Castro, the SBA National Ombudsman for Small Business, showed strong signs of support and was actively engaged with the group of DMEPOS providers that were in attendance. His role as the national ombudsman is to advocate for small businesses that face excessive fines, penalties, or unfair regulatory enforcement actions. He assured the group that the SBA is very aware of the problems associated with competitive bidding and would be addressing those issues with members of the Montana delegation in Helena this week. Likewise John Gallagher and Jay Witter recently met with the National Federation of Independent Businesses in Washington, D.C., earning the industry a new ally. The NFIB is comprised of 350,000 small and independent business owners united to promote and protect your right to own, operate and grow your business. What HME Providers Can Do The August Recess (Aug. 1 – Sept. 7) is an ideal time to meet members of Congress or congressional staffers to discuss rural rollout. VGM Government Relations is encouraging the August of Action, an effort to motivate HME providers to attend or host meetings in district. The government relations team will provide you with all the support you need. We will:

  • Schedule a face to face meeting for you with your member of Congress when they are in your district.
  • Provide you with a customized legislative coaching session and ongoing support.
  • Send you talking points and support materials needed to start the dialogue about HME with your health care leaders.
It will be important to discuss how your business and patients are or will be affected by the rate cuts. Prepare to tell anecdotes in support of fair rates for service. Currently the team has scheduled more than 30 meetings for August of Action. Learn more and sign up to participate here. Will Your Business Be Affected By the Rural Rollout? The official zip codes of which “rural areas” will receive the 10 percent add-on has not been released by the government. According to Mark Higley of VGM Regulatory Affairs, we can estimate where the areas will be by reading the final rule. CMS will either choose to use one of the two U.S. Census definitions or the definition offered by the Office of Management and Budget. Higley provides an “educated guess” that CMS will use the Office of Management and Budget definition of rural area, because it allows for fewer rural areas, and thus increases their “savings” estimate. To view the rural areas defined in your state, choose your state from the list on this webpage. Higley will provide more information on this topic in Connect editions to come. A Partnership of Many VGM Government Relations, in collaboration with AAHomecare, is committed to mitigating the rural rollout of competitive bidding. Success will rely on the efforts of many, including HME providers throughout the country, to actively engage their members of Congress now, during the August of Action, and as we close out the year in 2015. As part of our continued fight, we will continue to let you, our Members, and the industry as a whole know what you can do to fight this flawed program. If you want to get involved or have specific questions, please contact Emily Harken at