Patient Access to Durable Medical Equipment Act of 2016

Floor Speech

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I thank my colleague, Mr. Pitts. It is a pleasure to be working with him and with Mr. Pallone and Mr. Upton.

This legislation, as Mr. Pitts indicated, is going to give some relief to communities, particularly rural communities, from the imposition of changes in how charges are made in competitive bidding processes that have a significant potential to make inaccessible durable medical equipment.

I was a cosponsor, but the lead sponsor is here, Dr. Price, a good colleague and a really good doctor. Dr. Price, Legislator Price, came up with a pretty good bill that is going to help Georgia but also help rural Vermont, so I appreciate that.

The bottom line, the DME Competitive Bidding Program was created in 2003. It was aimed at a goal all of us have. It was trying to lower spending on durable medical equipment. It was well-intended, but it has had some serious consequences, especially for rural providers, like in Vermont, and I am sure parts of Georgia and other rural parts of the country.

By the way, when we do something, it can have a good intention, it can even accomplish some of its goals, but I think it always makes sense for us on both sides to step back after there is some history-- this went in in 2003--and take a look, kick the tires. What are some of the improvements that we can make so that we get back to the original intention and don't do harm that is unnecessary? And that is what the Price legislation is doing.

In January 2016, the Competitive Bidding Program began its nationwide rollout. That was under the new CMS guidelines. As a result, the rural areas saw significant cuts. It really does jeopardize access to this important equipment for beneficiaries.

The CMS continued its rollout in July with a second round of cuts. It further slashed reimbursement rates for DME across rural America, including Vermont.

In Vermont, we have an excellent equipment provider, Yankee Medical, that is reasonable in its price and incredibly good in its service. It will bring equipment to people all across rural Vermont. That is such a benefit for folks who can't get out of their homes.

The rural areas do have different challenges than urban areas. It is much more challenging for stakeholders to absorb these cuts. For instance, a small business in rural Vermont in a noncompetitively bid area may not have a large amount of Medicare-related businesses and, therefore, might not be able to afford the prices that a business in a much larger populated area could offer.

So this legislation is going to put on hold for 3 months what these prices will be. It is going to allow time for some adjustment and, hopefully, for us to consider other positive reforms that will be helpful to maintaining access to important healthcare equipment for folks in rural Vermont and rural America.

The bill contains a couple of other provisions, one of which I will speak about. My colleague on the Energy and Commerce Committee, Mr. Bucshon, was the lead sponsor and I was his cosponsor. As a way to pay for this--and that was cracking down on this Medicare fraud, where there has been a failure administratively--when a provider is found to be fraudulent in one district, that fraud is not then communicated to all other districts or States, so that fraudulent provider tries to just take their operation elsewhere. This is going to require that notification and it is going to shut down that fraud much more quickly, saving money, and then helping us to pay for this.

So this is practical legislation, the result of a compromise by the chairman and ranking member of the Energy and Commerce Committee, Mr. Pitts, and some of my colleagues. Mr. Loebsack of Iowa played a very, very active role in this legislation. Of course, Dr. Price did as well.

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