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The Darkest Hour is Just Before Dawn – Competitive Bidding Rural Relief and CRT Legislation Excluded from Omnibus

December 1944, Belgium – Low on supplies and ammunition, U.S. troops had been able to stop cold everything that had been thrown at them from all directions. Through the winter temperatures, the fighting never stopped. The troops received word that the German commander demanded U.S. troops honorably surrender in an effort to save them from total annihilation.

The German commander received this reply from General McAuliffe and the U.S. troops, “NUTS!” On December 26 General Patton’s 3rd Army broke through the German lines, allowing supplies to be flown in and the wounded to be evacuated.

The story of “The Battle of the Bulge” as told today.

We need to take inspiration from this story and apply to our life. Late last night, our hopes and dreams were deflated as the omnibus bill was released. Industry leaders were up all hours of the night scouring the omnibus bill for any mention of Medicare relief. What will we say in response? Same as the U.S. troops responded to the German commander. NUTS! We shall persevere!

Click here to read the release from AAHomecare.

We have come so far, and we cannot give up now. We need to continue to educate our legislators on the catastrophic effects these Medicare programs are having on DME suppliers and Medicare beneficiaries. We need to continue building relationships with members of Congress.

So many grassroots activities happened this year. Here are just a few.

Back in March of 2014, MAMES leaders Rose Schafhauser and Greg Lord of Great Plains Rehab together with Tom Powers of VGM and many others held an open house meeting with Sens. Heitkamp and Hoeven and Rep. Cramer. Kay Johnson and other MAMES members hosted a meeting with Sen. Thune to gain his interest. Since these meetings in North and South Dakota, these legislators have been in our corner. Iowa also had support of both their senators after MAMES members Leila Wilkerson, Colleen Brabec, Julie Creery and Kurt Johnson spent many hours on the phone with Sens. Grassley and Ernst offices.

Sen. Crapo has been a key to the process since he sits on the Senate Finance Committee. Thanks to meetings and relationships built by Big Sky AMES and Norco, Sen. Crapo was one of the first cosponsors of S.2312. Montana’s complete congressional delegation signed on following in-district meetings.

The group from ADMEA, led by Don Jones, was able to have numerous meetings with all of the Alabama delegation. PAMES members had many in-district meetings with key legislators including Sen. Wyden and Cathy McMorris-Rodgers. UTMED members and Jay Broadbent built relationships with Sen. Hatch’s office. Doug Coleman and CAMES worked tirelessly with his CO and WY congressional leaders.

Thad Connally and KMESA members held many in-district meetings. Thad recently met with the ever-powerful Senate Majority Leader, Sen. Mitch McConnell. Karyn Estrella and HOMES members successfully met with New England leaders. WAMES leaders met with Sen. Baldwin recently and gained her support. They also had a conference call with Rep. Paul Ryan’s office. The list goes on and on. Other grassroots activities include over 5000 messages in three weeks sent to members of Congress through VGM’s DCLink.

All of you deserve a standing ovation. But these incredible acts cannot be for nothing.

This battle is not over. If CMS and Congress ask us to surrender, we say “NUTS!”

Breaking Alert: HME and CRT urgent call to action

Capitol Hill is buzzing today as policymakers expect the year-end omnibus spending bill to be introduced late tonight or early tomorrow morning. This is the last big push in order for the necessary legislative remedies to be implemented into the omnibus bill needing to be passed Wednesday night in order to overt a government shutdown. VGM’s John Gallagher has created a short video outlining the importance of contacting your representative and senators through the Congressional Switchboard and the VGM DC Link.

Please click here to view the video!

Urgent Key Points when contacting your elected officials:

  1. Support legislation in the omnibus spending bill to mitigate the rural rollout of competitive bidding. (H.R. 4185 and S. 2312)
  2. Support CRT Accessories by delaying the policy of introduction into competitive bidding through the omnibus bill. (H.R. 3229 and S. 2196

Stay tuned for updates as now is crunch time, and we are in the 11th hour. Be sure to follow us on Facebook and Twitter as we will be posting updates as soon as we receive them!

Competitive Bidding Rural Relief Bill will be introduced tomorrow; bill to be included in Omnibus package

Rep. Tom Price’s (R-GA) office tonight reports that they are confident the highly anticipated rural relief bill will be introduced tomorrow. Amidst a tight time frame, we are also hearing the bill will find a place in the 2015 Omnibus spending packages. We will confirm both of these points tomorrow or later this week.

Today an article from Health Reform Insider reports, “There also is a chance that lawmakers will use the appropriations bill to mitigate durable medical equipment reimbursement cuts in rural areas driven by competitive bidding prices, sources say.”

It’s time for action, and we’re closer than ever! Let your members of Congress know the importance of the rural relief bill. Here are the talking points once again.

  • The nationwide expansion of the competitive bidding program on Jan.1, 2016 creates up to a 50 percent reimbursement cut, making it difficult to impossible to do business.
  • It is not uncommon for rural providers to travel 100 miles one way to deliver and service medical equipment, which is not accounted for in the reimbursement equation.
  • Home medical equipment companies that provide essential life supporting services to Medicare and other insurance beneficiaries will go out of business.
  • With medical equipment access issues on the rise for items like walkers, wheelchairs and oxygen, Medicare and Medicaid patients are having extreme difficulty receiving the equipment that they desperately need.

Click here to contact your elected officials.

Read the entire article from Inside Health Policy below.

Health Reform Insider
Health Care Policies In Play In Approps, Tax Extender Bills As Congress Finishes Up 2015 Business
Posted: December 7, 2015

Health care policies factor into both the omnibus-appropriations and tax-extenders bills that lawmakers are working on this week, although another short-term spending measure is likely in order to keep the government running past Friday as talks continue on a longer-term package. Although some want to include a hospital site-neutral payment measure in the upcoming spending bill, many lobbyists don’t expect that to happen this year. A more likely amendment is one to give providers a blanket hardship exemption for electronic health-records meaningful use requirements in 2015. There also is a chance that lawmakers will use the appropriations bill to mitigate durable medical equipment reimbursement cuts in rural areas driven by competitive bidding prices, sources say.

Tax extenders legislation also is a potential vehicle for major health care measures, including a delay of the Affordable Care Act’s taxes on the medical device industry and expensive employer-sponsored health plans.

Congressional committees also are busy this week. The Senate Special Committee on Aging on Wednesday holds a hearing as part of its probe into recent price spikes for off-patent drugs. Acting CMS Administrator Andy Slavitt testifies before the House Energy & Commerce oversight subcommittee on state-run health insurance exchanges, and the health subcommittee discusses six bills, including one to reauthorize nurse-training funding. The Senate health committee holds a hearing on opioid abuse.

Expanding support for S. 2312 to protect rural access for HME

Take Action NowWith the introduction of S. 2312, the DME Access and Stabilization Act, by Sen. John Thune (R-SD) and Sen. Heidi Heitkamp (D-ND) there is little time to spare in building a wave of support for this legislation. This bill is what will greatly soften a devastating blow to the DME industry, especially in the rural areas of the United States. The key bullet points for what this bill accomplishes are:

  • Establish a 30 percent adjustment for “rural” suppliers and 20 percent adjustment for other non-bid areas to address the challenge of serving large geographical areas (in place of the 10 percent proposed).
  • Provide a two-year phase-in for national price adjustments effective 2017 (in place of the six months proposed).
  • Eliminate the bid cap (in place of CMS proposal for cap at previous bid rates).
  • Re-establish fee schedule effective 2019. Request stakeholder medical equipment and services input regarding the following:
    • Travel distance and cost associated
    • Average volume
    • Clearing price
    • Number of providers in CB areas compared to non-CB areas
  • Apply regional Medicare competitive bidding rates to Medicaid in 2020

Now is the time to reach out to your senators and urge them to support or sponsor this legislation that offers some long overdue relief for providers. The bill already has a few co-sponsors that have been extremely supportive of the DME industry, they include: Sens. Pat Roberts (R-KS), Angus King (I-ME) and Mike Crapo (R-ID).

Please visit our VGM Action Center and message your senators by clicking here!

VGM’s John Gallagher has created a helpful video on the VGM D.C. Link that will give you an in-depth analysis and strategy of this legislation moving forward. Click here to view his video!

Round 1 2017 bidding advice from Mark Higley

If you are bidding in the “Round 1 2017”, the Competitive Bidding Implementation Contractor (CBIC) must receive your hardcopy financial documents on or before November 16, 2015, in order for the documents to be eligible for a covered document review and for you to be notified of any missing financial documents.

Don’t wait – send the required hardcopy financial documents TODAY!

The covered document review process gives bidders the opportunity to be notified of missing required financial documents. VGM urges all members bidding in the program to take advantage of this process.

Under the covered document review process, the CBIC will notify suppliers of any missing financial documents.

Important note: The review process only determines if there are any missing financial documents. It does not indicate if the documents are acceptable, accurate, or meet applicable requirements.

You’ll be notified by e-mail along with a letter indicating any missing financial documents within 90 days of the CDRD. The notification e-mail will be sent to the bidder’s registered authorized official and back-up authorized official. In addition to the e-mail, suppliers who are missing a financial document will also be sent a letter indicating the missing financial document(s). Those suppliers will be required to submit only the indicated missing financial document(s) within 10 business days of the notification. After the bid window closes, bidders may only submit the requested financial documents identified as part of the CDRD process and cannot submit corrections to any other required documents.

Questions? Contact Mark Higley at or 888.224.1631.

Read more at VGM National Competitive Bidding Services is committed to being the industry’s top resource. We are driven to educate and assist our members through the Competitive Bidding process, providing the necessary resources and ensuring their best chance at making the proper bidding decisions. Whether you choose to bid as an individual provider, join a network, or take advantage of subcontracting options, VGM NCB Services has the tools you need.

Seminar Series 2016

Join Mark and his colleagues at an upcoming Seminar Series near you. During the seminar, Mark will be presenting “Preparing for the Expansion of the Competitive Bidding Program to Rural America in 2016,” with specific information applicable to reimbursements in non-bid areas (and a map of the areas affected). Other topics include current audit issues, acquiring a bid contract, and an analysis as to where the industry is heading. Click here or visit

Powerful ‘Dear Colleague’ letter highlights concerns over rural rate cuts- Your action is needed now

Congressman Scott Tipton (R-CO) has composed a “Dear Colleague” letter asking for rural rollout relief. Representing rural Colorado, the Congressman’s letter, addressed to leaders of the House Committee on Ways and Means, calls attention to the severe consequences of suddenly reduced payment rates.

In his letter he writes, “There are already larger barriers to access for home health services in rural parts of the country, and decreasing compensation for the services required to deliver equipment to this area reduces the likelihood that providers will continue to operate there.”

He also calls attention to the following:

  • The 10 percent regional single payment amount will not cover the cost of providing services
  • CMS’ phase-in timeline is unrealistic, allows no time for business to adjust their models
  • Two reports are set to be released over the course of 2016 that will provide more information, allowing officials to determine if the program should be continued
  • HME companies are preemptively laying off employees in anticipation of the reduction
  • Rural constituents and HME providers are gravely concerned about the potential impact the cuts will have on Part B beneficiaries

The letter is specifically asking the Ways and Means Committee chairman and ranking member to evaluate all available legislative remedies to prevent the reimbursement cuts in 2016 and “ensure access to DMEPOS for individuals and families in rural areas.”

What does this mean to us?

The actions we have taken to communicate our issues to Congress are working. Now it is time to sprint into action again to encourage congressional members to sign on to Rep. Tipton’s letter.

By signing this letter, we are again asking members to be supportive of the home medical equipment industry and the people they serve. The letter, loaded with signatures, will head to the Ways and Means Committee as a powerful display of importance of the issue.

Please contact your member of Congress now. The deadline is close of business day on Nov. 16. Don’t waste any time; it takes just a minute. Click here to send a message to your legislator today!

From the desk of Mark Higley: Fall Seminar Series starts next week. Reserve your seat today!

mark-higleyFall Seminar Series mission is to deliver relevant and timely information for our members to help them COMPETE, PROSPER and SUCCEED so they can continue to do what they do best…take care of patients.

Register today for a seminar nearest to you. Click here to view the list of cities Mark and the group will be visiting the next several weeks and the presentation line-up. The topics vary based on the location.

Click here to reserve your seat today!

Rep. Rod Blum Visits and Supports VGM

rod blum visit 9.21.15VGM had the honor of hosting freshman Congressman Rod Blum (R-IA) for a tour and hosted a fundraiser with him afterwards. This is Rep. Blum’s third visit to VGM since his election in 2014 and each time he asks industry-specific questions to learn more about the HME industry and our challenges.

Rod Blum visit 2  9.21.15Rep. Blum understood the importance of keeping providers in business to keep patients in their homes. We discussed the negative impact that competitive bidding has had on providers and the excessive audits that CMS is imposing on independent providers. We look forward to continue working with Rep. Blum as we get closer to the introduction of Chairman Price’s language on mitigating the effects of competitive bidding. We’ve asked him to sign on to all of our legislation including CRT and O&P.

August of Action Wrap Up

It seems like yesterday we were at the Heartland conference having discussions with DME suppliers about how to engage your local politicians this summer and make them aware of our issues. Well the August recess is officially over, but we are still scheduling meetings – including many follow up meetings! These follow up meetings are due to the intriguing and even scary stories that DME suppliers have told their members of Congress.

We sincerely thank all of you who took the time this summer to speak to Congress about concerns of the DME industry. Below is a photo gallery of our campaign.

August of Action wrap up image

Technology and Social Media is Changing Congress

By Collin Brecher, VGM Government Relations

The success of independent suppliers of the DMEPOS industry across the nation seems to be completely at will to the decisions of CMS and the government. It is very easy for a provider to feel helpless and ask, “I am just one business, what could I possibly do to change the path that the industry is going down?” The answer to that question is simple, contacting elected officials at any level in government is one of the most beneficial things you, as a provider, could do.

One of the most common responses that the Government Relations team gets at the federal level is “I am not hearing from providers and beneficiaries what challenges they are facing.” This is a very winnable battle, whether it be an email, phone call, or contact through social media. Elected officials WANT to hear from their constituents and business owners which means providers stand to gain a lot of ground when contacting a Congressman or Senator. Here are the three key points to contacting your elected officials.

HOW: With advances in technology and the sweeping changes that social media has brought to Capitol Hill, accessing your elected officials is easier than ever. Nearly every member of Congress has social media accounts like Twitter or Facebook. Sending them a tweet or post on Facebook only takes a few moments and is a great way to get the conversation started about concerns of your business. These posts are a great stepping stone to begin sending emails, or a letter directly to your member of Congress and starting a dialogue with them.

WHAT: Members of Congress are representing hundreds of thousands of citizens from their respective states. This is a big reason it is easy to feel lost in such a large crowd of people. Fear not, your voice can still easily be heard. Your Congressman may be more accessible than you might think. Townhall meetings and events happen all over the state at times like Congress’s August Recess, when members of Congress have an entire month dedicated to being back home. The main purpose of the month long break is for officials to hear the concerns of everyday citizens. This is a great time to meet with them in person. Congressmen also have staff members specialized in the healthcare industry that are just as beneficial to beginning that crucial dialogue.  Asking for a few minutes of time with a staff member of your member of congress and bringing in concise and direct bullet points of what issues you face goes a long way.

WHY: Contacting your Congressman and Senator is greatly influential and you stand to gain a great relationship with them. A study from the Congressional Management Foundation found that “64% of the senior managers and social media managers surveyed think Facebook is a somewhat or very important tool for understand constituent views and opinions.” Contacting through Twitter was not far behind at just under 50%. What these posts and tweets can lead to is the best contact of all, a face to face meeting with the Congressman or his trusted staff. One of the greatest successes that is common to see is congressional offices relying on the input of providers how different bills could affect their business.

All that it takes to build that relationship is to reach out and start the dialogue. The VGM Government Relations team is more than happy to assist you in contacting your members of Congress and coordinating a meeting with them. If you are planning on attending the 2015 Heartland Conference please stop by the Government Relations booth and start the dialogue during our “August of Action.”