Home Health & Hospice Week

The wheels of health care reform legislation are turning slowly, and home care providers are hoping they don't get crushed under them before it's all over.

The Senate's Health, Education, Labor and Pensions (HELP) Committee has passed its health care reform bill. The bill doesn't carry specific provision for Medicare cuts, since HELP is not a committee of jurisdiction for that program. But it does contain the provisions of the Community Living Assistance Services and Supports (CLASS) Act, which would "significantly expand" federal payment for non-medical long-term care in the home, notes the National Association for Home Care & Hospice. With the House's so-called tri-committee bill calling for major cuts to home health agencies and hospices (see Eli's HCW, Vol. XVIII, No. 25, p. 194), all eyes are on the bipartisan bill Senate Finance Committee members are currently working on. Observers expect the Senate Finance legislation to look the most like the final health care reform package, due to its support from lawmakers on both sides of the aisle -- if they can agree. At press time, committee members appeared poised to miss the August recess deadline for legislation that President Obama was calling for.

Another piece of bad news in the House is that Democratic leadership is appeasing the socalled Blue Dog coalition of conservative Democrats by agreeing to give the Medicare Payment Advisory Commission, or at least another independent executive branch body, power to set Medicare rates independently, according to press reports. That could spell bad news for HHAs, whom Med- PAC has targeted for rate cut  recommendations for many years.

The MedPAC move got a boost from Health and Human Services Secretary Kathleen Sebelius on "Meet the Press," too.

Bright spot: The House tri-committee bill also could include another one-year moratorium on phase-out of the hospice budget neutrality adjustment factor (BNAF), NAHC reports. The House Ways and Means Committee included that provision in its version of the legislation. The House Energy and Commerce Committee has also included the CLASS Act provisions in its version of the bill, NAHC notes.

Suppliers Fight Oxygen, Bidding Battles Meanwhile, except for a few relatively small provisions, durable medical equipment has largely been left out of the reform debate. But suppliers are battling to win back ground on the oxygen cap and upcoming relaunch of competitive bidding. The health care reform package will be the most likely vehicle to gain support in these areas, stresses the National Association for Independent Medical Suppliers. Suppliers' efforts might be hampered by a recent damaging report on CNN, however. CNN profiled a Medicare beneficiary who received a wheelchair for about $1,200 in rental fees when she could have bought it for about $350 from the company.

"In a somewhat unbalanced report, CNN portrayed the DME industry as profiteers based on one wheelchair story with many errors and incomplete facts," NAIMES protests.