Patient Access to Durable Medical Equipment Act of 2016

Floor Speech

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Mr. PALLONE. Mr. Speaker, I cannot support a delay in the expansion of the competitive bidding program. Competitive bidding for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) has saved the Medicare program billions of dollars. And lowering costs for the Medicare program means lower copayments for Medicare beneficiaries.

Over the years, it has been widely documented by the HHS Office of Inspector General and the Government Accountability Office that Medicare payments for DMEPOS far exceeded reasonable costs. This is why Congress passed legislation requiring competitive bidding for DMEPOS incrementally. Since 2011, CMS has closely monitored all beneficiaries in the competitive bidding areas, and there have been no access concerns. Health outcomes are steady compared to before Medicare began the competitive bidding program. CMS will continue to monitor health outcomes, and until we see any concerns, I do not believe we should stop the progress in saving money for both beneficiaries and the Medicare program.

That said, the Medicaid policies in this legislation were passed by the House in March of this year, 406-0, after consideration by the House Energy and Commerce Committee. The first policy, the Medicaid DOC Act, is an initiative first introduced by Reps. Collins and Tonko and would require states that participate in fee-for-service Medicaid to publish electronic provider directories. It's important for patients to know what providers participate in the Medicaid program. States are required to provide electronic directories in managed care, but the same requirement does not exist across the full Medicaid program. The Committee worked throughout the legislative process to streamline this policy with current federal provider directory regulations in Medicaid managed care. The legislation details the minimum items that must be included in a provider directory, but also allows states to go beyond these standards.

The second policy is an initiative first introduced by Reps. Bucshon, Welch, and Butterfield and would provide CMS with critical tools to keep patients safe, protect taxpayer dollars, and protect the integrity of the Medicaid program. The ACA included a provision that prohibited disqualified providers from Medicare or one state Medicaid program from simply crossing state lines and receiving payments in another state Medicaid program. Unfortunately, as drafted, the law has been hard to implement, because states don't have a consistent or standardized way of knowing when a specific provider has been terminated by Medicare or another state. States are not currently required to report this information, and if it is reported, it is in many differing formats, limiting the data's usability. This provision would require all states to report information on fraudulent providers to the Secretary for inclusion in a currently existing termination database that is accessible to all states. The legislation also requires the Secretary to develop uniform criteria for states to use when submitting information. I supported both of these commonsense policies in the past, and I continue to support them today.

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