Take Action! Share our New Impact Study with Congress
Study Shows How Jan. 1 Cuts for Non-CB/Non-Rural Suppliers are Devastating Suppliers and Threatening Access to Care
Share the Impact Study with Your Senators and Representative – and Include Your Own Experiences and Perspectives After 6+ Months Under These Rates
AAHomecare's nationwide 75/25 Impact Study provides comprehensive look at how the loss of the 75/25 rates in non-CB areas are causing
suppliers to pare back product offerings, reduce service areas or close locations, cut staff, or use their own savings to stay in operations. More than one-in-10 suppliers are
considering shutting down due to unsustainable rates. These difficult decisions ultimately threaten access to HME for millions of patients and their caregivers.
The survey findings provide an opportunity to reach out to your legislators on Capitol Hill to show the widespread financial stress our industry is facing and underscore the urgent need to restore the 75/25 rates. If the January 1 cuts are impacting your business, please commit to reaching out to your members of Congress at least once in both August and September on the issue.
Messages & Tips
Who to Contact – If you don't already have a relationship with your legislators' staff, call their DC offices and ask for the name and
email of the staffer who handles healthcare issues.
Share the Impact Survey – You can share our aahomecare.org/impact link or download the survey brief and full report PDFs in your email.
Main Messages - Please put these ideas in your own words for maximum impact.
- Intro: I wanted to share new survey that shows how the January 1 Medicare reimbursement cuts for durable medical equipment are impacting suppliers nationwide. Lower reimbursements, even as operational and product costs continue to rise, are causing many suppliers limit their offerings, reduce service areas, lay off staff, close locations, or even consider going out of business altogether. The survey also shows that these cuts are being reflected in rates from other payers, such as Medicare Advantage, commercial payers, and Medicaid.
- Share your own specific impacts. Talk about operational and product decisions that you're making or considering, and how they might impact your patients and communities going forward. You can also give examples of product or operational costs that have risen even as your rates have gone down. If there's something in the survey report that particularly reflects your experience or resonates with you, refer to it (and what page it occurs on in the report). Looking for inspiration? Here's some open-ended responses we received in the survey.
- The Principal Ask: Please work to make sure that Congressional leadership makes restoring the 75/25 blended Medicare reimbursement rates a priority for the next appropriate healthcare or Omnibus legislative package. We need this relief this year before these cuts do more damage.
Want to expand on your message? Here's a few additonal points you can make in your original outreach, or save for a follow-up.
- These cuts averaged 20% for the top 25 DME HCPCS codes, with many categories having steeper reductions (you can share the analysis here).
- Current Medicare rates haven’t had market-based adjustments since 2016 and fail to factor the rising product and operational costs. Relief is needed to prevent access issues for seniors, people with disabilities, and those with chronic respiratory conditions.
- If you’re among the sizable cohort of suppliers impacted by the Change Healthcare disruption, you can note that the current lowered reimbursement rates and narrow (or negative) margins have made it even harder to withstand shocks like that one.
- For Senate members, you can also note that S. 1294 passed the Senate Finance Committee by a unanimous vote on Nov. 8, 2023.
- For House members, you can share that H.R. 5555 passed the Energy & Commerce Committee by voice vote on Dec. 6, 2023.
Need Help? We Are Here for You!
The AAHomecare team is happy to help you craft your note, find the appropriate contact, respond to any feedback you get from the Hill, or answer any other questions on
this issue. Please email Gordon Barnes (gordonb@aahomecare.org) for assistance.
Your Advocacy Makes the Difference
The HME community's grassroots advocacy was the driving force for advancing 75/25 relief through the Senate Finance Committee and House Energy & Commerce Committee
last Fall. Unfortunately, provisions from our legislation were among the many other measures that were cut from Appropriations legislation this Spring as the scope of those bills
narrowed.
Now we need to make sure that Congress hears directly from every corner of the HME community – passionately and repeatedly – on what these cuts are doing to suppliers and the downstream impacts on patients and caregivers, and why we urgently need this relief this year.
Find More
ITEM Coalition Letter - Dec. 2024
75/25 Impact Survey page – aahomecare.org/impact
Full Report
Survey Brief
House Issue Brief – Congress Needs to Support HR 5555 to Provide Critical Relief for DME in
CBAs and Non-Bid Areas
H.R 5555 bill Text and co-sponsors
Senate Issue Brief – Support S. 1294: Legislation to Continue Relief for Durable
Medical Equipment in Non-Competitive Bidding Areas
S. 1294 bill text and co-sponsors