Once More Unto the Breach

Published in Government Relations on July 26, 2023

This was originally featured on Medtrade.com.

The phrase “Once more unto the Breach Dear Friends” is from a famous speech from Shakespeare’s play “King Henry V”. The phrase means “let us try one more time” or “try again”. We in the DMEPOS industry should well relate to this phrase. The word Breach, by definition, means a broken, ruptured, or torn condition or area of a gap (as in a wall) made by battering. This industry should be commended for its efforts over the last 10 to 15 years.

With continued battering, we have begun to open a gap/breach in reimbursements. In recent years the industry has been successful with many things legislatively and regulatorily; from the 50/50 payment Blend for Rural Areas and the 75/25 Blend for Non-Rural Areas, to the two-year (2020-2022) relief from 2% Sequestration cuts, to name just a few.

Sadly, if we don’t continue to “Try again”, all that work over the years to widen the breach could come to a close. Now is the time for all providers to ask themselves; “Am I doing what I can to make a difference?” “Am I making a good faith effort?”

It has been our national association (AAHomecare) and other industry stakeholders (such as VGM) who have led the way into the breach, but it is the strength of the state associations and their grassroots efforts and relationships that have “widened the gap” that allows us to rush forward for additional relief and a brighter future for DMEPOS.

Over the course of the last 15 years, the DME industry has lost over 41% of PTAN rooftops. To be successful, we need strength in numbers. To achieve this, we need to muster and unite the remaining providers. We have learned over the years that where we are strong with state association membership, we are strong with congressional and state legislative relationships. Also, with a strong state associations comes a better working relationship with state (Medicaid) Agencies. None of that is possible if we don’t have boots on the ground at the grassroots/state level.

Over the course of the next 18 months (2023-2024) we will indeed need all our efforts at the Breach. We will need efforts at both the federal and state level. At the federal level we have our Senate Bill ~ S.1294 (Competitive Bidding Relief Act of 2023) that was introduced by Senator Thune (R-SD) and Senator Stabenow (D-MI). This bill provides an extension of the 75/25 blended rate for non-rural areas to Dec 31, 2024. The purpose is to sustain providers long enough to get CMS to decide a final course of action on the competitive bid program (CBP) that has constrained provider reimbursement since 2016.

Hopefully within weeks we will have a House of Representatives companion bill to S.1294. We need co-sponsors for both bills and to accomplish that we need providers and state associations to engage and build relationships with their federally elected officials. To this end, VGM has worked with AAHomecare to build and promote the GAP (Government Accountability Project) program. The idea of the GAP is to work with state associations and ensure the industry has at least one provider that has a regular engaging relationship with their elected official (Senate or House) in the district or state.

The hope is to have multiple providers for each member of Congress. We also intend to work on multiple other bills at the Federal level (Mobility, O&P…ect). At the State level we have had success in the last several years with elimination of State Tax (OK, WA) and Licensure (KY, TN, AL, OK).  States need to continue to win on these issues at the same time they are facing challenges from Medicaid, MA reimbursement and Audit Issues.

The Covid Pandemic, if nothing else, taught the healthcare industry and Congress that the cheapest and most effective place to care for patients is in the home. The time is right for our industry to expand the breach and to finally climb out of the pit that is the competitive bidding program. To accomplish this, it’s imperative that we have the strength at the grassroots / state association level.

It is strength in numbers that member of Congress and bureaucrats understand. To join your state association is an easy process. In many cases, yearly membership is less than $1,000 a year. Small wins at the state level will show ROI tenfold. It is time to ask ourselves; “Am I doing what I can to make a difference?” Let’s work together to move forward with the collective rally cry—Once more unto the breach dear friends!


TAGS

  1. vgm
  2. vgm government

From Our Experts

Government Relations Advocate for the Breast Cancer Patient Equity Act thumbnail Government Relations Advocate for the Breast Cancer Patient Equity Act The week of June 3rd, Nikki Jensen, VP of Essentially Women and Ike Isaacson, SVP of VGM Government & Regulatory Relations traveled to Washington D.C. to advocate for the Breast Cancer Patient Equity Act. Williams Brothers Healthcare Hosts Meet-and-Greet Event with Rep. Erin Houchin thumbnail Williams Brothers Healthcare Hosts Meet-and-Greet Event with Rep. Erin Houchin Last week, Williams Brothers Healthcare organized a meet-and-greet event featuring Representative Erin Houchin (R-IN-9) to address crucial topics related to HME services and the challenges faced by providers. OMEPA's Legislative Triumphs: A Tale of Relationships and Persistence thumbnail OMEPA's Legislative Triumphs: A Tale of Relationships and Persistence Over the past few legislative sessions, Oklahoma Medical Equipment Providers Association (OMEPA) has navigated a legislative rollercoaster. Their commitment to building relationships and advocating for patients has led to significant wins. Audit Climate – Taking The Temperature thumbnail Audit Climate – Taking The Temperature As we near the midpoint of 2024, what are the main billing/reimbursement headaches being faced by providers? [Vlog] Oxygen Policy Update thumbnail [Vlog] Oxygen Policy Update Listen in as Ronda Buhrmester clarifies the language of the oxygen policy around the co-signature that is highly recommended. Elimination of Noncompete Agreements - FTC Final Rule thumbnail Elimination of Noncompete Agreements - FTC Final Rule A 570-page final rule released by the FTC on April 23 will effectively put an end to the use of noncompete agreements between employers and employees. The final rule is scheduled for publication in the Federal Register on May 7, 2024, and will go into effect 120 days from publication (September 4, 2024), barring the results of any legal challenges to the rule. OMEPA Celebrates Another Successful Capitol Rally Day thumbnail OMEPA Celebrates Another Successful Capitol Rally Day On April 23, OMEPA members gathered at the Oklahoma Capitol in support of HB1712. Government Relations: Speak With One Voice thumbnail Government Relations: Speak With One Voice The DMEPOS industry must show a unified front, speak with a unified voice, and together be champions of change.