12/20/2021

AAHomecare’s Outlook and Analysis on Medicare Issues Heading Into 2022

Congress passed legislation that keeps across-the-board 4% PAYGO cuts to Medicare reimbursement from taking effect in 2022 and extends the pause on 2% sequestration cuts through the first quarter of 2022.  President Biden signed the measure into law on Friday.

According to AAHomecare, stopping the PAYGO cuts will keep $429 million more in HME suppliers’ coffers in 2022.  In addition, delaying full implementation of the 2% sequester will prevent an additional $80 million in cuts for now, although that $80 million measure of relief will be balanced by a temporary increase in the sequester in 2030. 

Averting the PAYGO cuts and long moratorium on the 2% Medicare sequester dating back to April 2020, along with the CPI-U adjustments reported earlier by AAHomecare, and other relief efforts related the COVID-19 public health Emergency, allow the HME community to continue to provide high quality care and lessen the stress on hospitals, nursing facilities, and clinicians during the ongoing pandemic.

Now the HME community waits for a long-anticipated DME Final Rule.  AAHomecare and other HME stakeholders have made the case in comments and direct outreach to CMS officials to include these measures in the rule:

• Permanent adoption of 50-50 blended rates for rural areas.
• Permanent adoption of 75-25 blended rates for other non-CBAs. 
• Provide a meaningful positive adjustment for rates on former CBAs that reflects the market realities faced by the HME community. 

While we hope CMS will support these measures, AAHomecare is continuing to work with HME champions on Capitol Hill on legislation should it be needed to stabilize reimbursement.  Once CMS reveals their plans for reimbursements going forward, HME advocates will need to make a strong and persistent case for realistic, sustainable, market-driven rates. 

OAMES appreciates AAHomecare’s leadership on these national issues and looks forward to working together in 2022!