WASHINGTON, D.C. – Today, Congressman Tom Price, M.D. introduced H.R. 5210, the Patient Access to Durable Medical Equipment (PADME) Act, a bipartisan solution that would preserve patient access to durable medical equipment (DME). By preventing severe cuts to Medicare DME reimbursement rates scheduled to take effect July 1, 2016, the legislation will ensure that DME providers are able to continue to meet the needs of Medicare patients and ensure that beneficiaries have access to quality items and services in all parts of the country. Examples of DME include blood sugar monitors, canes, crutches, hospital beds, power wheel chairs, and oxygen tanks.
Joining Congressman Price in co-sponsoring this legislation are Representatives David Loebsack (D-Iowa), Cathy McMorris Rodgers (R-Washington), Peter Welch (D-Vermont), Diane Black (R-Tennessee), Marsha Blackburn (R-Tennessee), Rod Blum (R-Iowa), Charles Boustany (R-Louisiana), Bradley Byrne (R-Alabama), Chris Collins (R-New York), Kevin Cramer (R-North Dakota), Scott DesJarlais (R-Tennessee), Tammy Duckworth (D-Illinois), John Duncan (R-Tennessee), Renee Ellmers (R-North Carolina), Bill Flores (R-Texas), Bob Gibbs (R-Ohio), Louie Gohmert (R-Texas), Brett Guthrie (R-Kentucky), Gregg Harper (R-Mississippi), Andy Harris (R-Maryland), Lynn Jenkins (R-Kansas), David Joyce (R-Ohio), Mike Kelly (R-Pennsylvania), Billy Long (R-Missouri), Blaine Luetkemeyer (R-Missouri), Markwayne Mullin (R-Oklahoma), Tim Murphy (R-Pennsylvania), Kristi Noem (R-South Dakota), Collin Peterson (D-Minnesota), Mike Pompeo (R-Kansas), James Renacci (R-Ohio), Phil Roe (R-Tennessee), Austin Scott (R-Georgia), David Scott (D-Georgia), Jason Smith (R-Missouri), Glenn Thompson (R-Pennsylvania), Pat Tiberi (R-Ohio), Scott Tipton (R-Colorado), Ann Wagner (R-Missouri), and Ryan Zinke (R-Montana).
“Georgia's seniors ought to have access to quality health care,” said Congressman Tom Price, M.D. “Every single day, many rely on durable medical equipment such as wheel chairs, oxygen tanks, and canes to maintain their health and wellbeing. This bipartisan effort seeks to allow providers of this equipment the ability to continue to supply lifesaving medical supplies to patients regardless of where they live.”
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-South Dakota) and Heidi Heitkamp (D-North Dakota) previously introduced S. 2736, the Patient Access to Durable Medical Equipment Act of 2016, a similar companion bill.