Today, Eastern Washington Congresswoman Cathy McMorris Rodgers (WA-05), co-chair of the House Rural Health Care Coalition, joined a bipartisan group in introducing the Patient Access to Durable Medical Equipment (PADME) Act (H.R. 5210), which would preserve patient access to durable medical equipment (DME) in non-competitive bid areas, the majority of which are rural communities. 

“Seniors of all backgrounds rely on durable medical equipment to go about their daily lives – whether it’s to simply walk around without falling or to breathe normally when their lungs can no longer do it on their own,” said McMorris Rodgers. “But this equipment cannot save lives if it isn’t made available to those who need it most, especially in rural areas where barriers to access care may already exist. I am grateful for Chairman Tom Price (R-GA) as well as Reps. Peter Welch (D-VT) and Dave Loebsack (D-IA) for their collaboration in introducing this important legislation, and working to ensure that seniors in Eastern Washington and across the country have access to quality medical equipment.”

Currently, a second round of severe cuts to Medicare DME payment rates are scheduled to take effect on July 1, 2016, and this legislation will ensure that DME providers are able to meet the needs of Medicare patients and guarantee they have access to quality items and services, including blood sugar monitors, canes, crutches, hospital beds, oxygen tanks, and more.

BACKGROUND:

The Competitive Bidding Program (CBP) was created by the Medicare Modernization Act of 2003. The Congressional objective in requiring Medicare to use competitive bidding to establish payment amounts for DME was intended to reduce Medicare and beneficiary expenditures and ensure that beneficiaries have access to quality items and services. The CBP has failed patients because it does not hold bidders accountable, does not ensure that bidders are qualified to provide the products in the bid markets, and produces bid rates that are financially unsustainable. More than 240 market auction experts and economists have warned that the Medicare competitive bidding program is unsustainable in its current form.

In January 2016, the competitive bidding program for DME began its nationwide rollout. As a result, many areas, including rural areas, saw significant cuts, jeopardizing access to DME for beneficiaries. For many rural providers, these new rates will not even cover the cost of delivery for the item.

An extension of the current DME rate is necessary to avert deep cuts in reimbursement following the rollout of Medicare’s competitive bid pricing into non-competitively bid areas.

The PADME Act would provide relief by extending the current reimbursement rates of DME in non-competitively bid areas in order to provide Congress with additional time to monitor its effects in rural areas. The PADME Act also seeks to address the underlying issues with DME reimbursement under the CBP.

For information on bidding areas, click here and click here to read the entire PADME Act bill text. 

Senators John Thune (R-SD) and Heidi Heitkamp (D-ND) previously introduced the Patient Access to Durable Medical Equipment Act of 2016 (S. 2736) in the U.S. Senate, a similar companion bill.