Disability Community Support for Protecting Patient Access to Durable Medical Equipment Act of 2016 (PADME) (H.R. 5210)

Background:

In the addition of the Medicare Modernization Act by the Centers for Medicare and Medicaid Services (CMS), legislators encouraged a competitive bidding process meant to drive down the prices and increase the quality of medical devices for consumers. This competitive market system, however, has only promoted low-quality products that, more often than not, are failing to fulfill their purpose.

Not only has the CBP failed because it does not hold suppliers accountable for faulty equipment and services, it has also set prices for necessary medical equipment, such as Durable Medical Equipment (DME), at unsustainably low levels.

CMS recently announced that it would be making major reimbursement cuts that would dramatically reduce the number of suppliers that could afford to provide such products. Reimbursement cuts are set to work in two parts – one on January 1st, 2016 and the second on July 1st, 2016.

CMS has also proposed extending competitive regional prices to non-competitive regions, typically rural areas where access to DME is already limited.

Implementing the Protecting Patient Access to Durable Medical Equipment (PADME) Act of 2016 would prevent secondary cuts to non-competitive area funding for at least 15 months, giving legislators time to assess DME quality and services in those areas.

This ruling would also require suppliers to meet specified levels of quality and set a bid ceiling on DME products. These changes are to ensure that suppliers are held accountable and that bids remain competitive and in the best interest of the consumer.

 

Status:

This bill was introduced by Tom Price (R-GA6) on May 12, 2016 to the House Committee on Ways and Means as well as the House Committee on Energy and Commerce. It was further referred to and passed by the House Subcommittee on Health. It has since been passed onto and read twice by the Senate Committee on Finance, where it awaits further review.

 

Key Terms:

Durable Medical Equipment – Equipment covered under Medicare Part B that consists of long-lasting medical equipment meant to assist an individual with daily life in the home. Such technology may consist of blood glucose monitors, crutches, canes, oxygen equipment, nebulizers, etc.

Competitive Bidding Program – This program was established to lower prices and to provide better quality durable medical equipment. Suppliers will bid on an area to have their product available through Medicare.

Reimbursement rates – The amount that the government will repay medical providers for their services in comparison to private insurance.

 

Cosponsors:
House of Representatives
Aderholt, Robert [R-AL4]
Allen, Rick [R-GA12]
Barletta, Lou [R-PA11]
Barr, Garland “Andy” [R-KY6]
Bilirakis, Gus [R-FL12]
Bishop, Rob [R-UT1]
Black, Diane [R-TN6]
Blackburn, Marsha [R-TN7]
Blum, Rod [R-IA1]
Boustany, Charles [R-LA3]
Brooks, Mo [R-AL5]
Bucshon, Larry [R-IN8]
Byrne, Bradley [R-AL1]
Cartwright, Matthew [D-PA17]
Chabot, Steve [R-OH1]
Chaffetz, Jason [R-UT3]
Cole, Tom [R-OK4]
Collins, Chris [R-NY27]
Collins, Doug [R-GA9]
Cook, Paul [R-CA8]
Cramer, Kevin [R-ND0]
Crawford, Eric “Rick” [R-AR1]
Davis, Rodney [R-IL13]
DesJarlais, Scott [R-TN4]
Duckworth, Tammy [D-IL8]
Duffy, Sean [R-WI7]
Duncan, John “Jimmy” [R-TN2]
Ellmers, Renee [R-NC2]
Emmer, Tom [R-MN6]
Flores, Bill [R-TX17]
Forbes, Randy [R-VA4]
Fortenberry, Jeff [R-NE1]
Gibbs, Bob [R-OH7]
Gohmert, Louie [R-TX1]
Graves, Sam [R-MO6]
Graves, Tom [R-GA14]
Guinta, Frank [R-NH1]
Guthrie, Brett [R-KY2]
Harper, Gregg [R-MS3]
Harris, Andy [R-MD1]
Hartzler, Vicky [R-MO4]
Heck, Joseph [R-NV3]
Holding, George [R-NC13]
Hudson, Richard [R-NC8]
Huelskamp, Tim [R-KS1]
Jenkins, Evan [R-WV3]
Jenkins, Lynn [R-KS2]
Johnson, Bill [R-OH6]
Joyce, David [R-OH14]
Kelly, Mike [R-PA3]
King, Steve [R-IA4]
Kirkpatrick, Ann [D-AZ1]
Kuster, Ann [D-NH2]
Lamborn, Doug [R-CO5]
Langevin, James “Jim” [D-RI2]
Latta, Robert [R-OH5]
Loebsack, David [D-IA2]
Long, Billy [R-MO7]
Luetkemeyer, Blaine [R-MO3]
Marchant, Kenny [R-TX24]
Marino, Tom [R-PA10]
Massie, Thomas [R-KY4]
McKinley, David [R-WV1]
McMorris Rodgers, Cathy [R-WA5]
Miller, Candice [R-MI10]
Mooney, Alex [R-WV2]
Mullin, Markwayne [R-OK2]
Murphy, Tim [R-PA18]
Neugebauer, Randy [R-TX19]
Noem, Kristi [R-SD0]
Palazzo, Steven [R-MS4]
Palmer, Gary [R-AL6]
Paulsen, Erik [R-MN3]
Peters, Scott [D-CA52]
Peterson, Collin [D-MN7]
Pingree, Chellie [D-ME1]
Pittenger, Robert [R-NC9]
Pocan, Mark [D-WI2]
Pompeo, Mike [R-KS4]
Renacci, James [R-OH16]
Rigell, Edward “Scott” [R-VA2]
Roby, Martha [R-AL2]
Roe, David “Phil” [R-TN1]
Rogers, Harold “Hal” [R-KY5]
Rogers, Mike [R-AL3]
Rokita, Todd [R-IN4]
Rothfus, Keith [R-PA12]
Rouzer, David [R-NC7]
Ryan, Tim [D-OH13]
Schrader, Kurt [D-OR5]
Scott, Austin [R-GA8]
Scott, David [D-GA13]
Shuster, Bill [R-PA9]
Simpson, Michael “Mike” [R-ID2]
Smith, Adrian [R-NE3]
Smith, Jason [R-MO8]
Stewart, Chris [R-UT2]
Thompson, Glenn [R-PA5]
Tiberi, Patrick “Pat” [R-OH12]
Tipton, Scott [R-CO3]
Visclosky, Peter [D-IN1]
Wagner, Ann [R-MO2]
Welch, Peter [D-VT0]
Wenstrup, Brad [R-OH2]
Westerman, Bruce [R-AR4]
Westmoreland, Lynn [R-GA3]
Whitfield, Ed [R-KY1]
Young, David [R-IA3]
Zinke, Ryan [R-MT0]