Industry still faces an uphill battle in this budget-cutting year. Home health agencies breathed a sigh of relief when President Obama issued his proposed budget for 2012 on Feb. 14. The budget contains no home health copayments, in spite of a recommendation for one that the Medicare Payment Advisory Commission makes in its forthcoming March report to Congress (see Eli's HCW, Vol. XX, No. 4, p. 26). It also contains no Medicare provider reimbursement cuts. Home care doesn't get off scot free in the President's budget proposal, however. The budget calls for increased fraud and abuse fighting activities. In particular, it calls for a system to validate physicians' orders for high-risk services, including home health services and durable medical equipment, the National Association for Home Care & Hospice points out. What that would actually translate into operationally is unclear. On the DME side, the proposal calls for Medicaid payment rates to be tied to competitive bidding rates. "This proposal would be a disaster for the already-strapped homecare sector," says Tyler Wilson with the American Association for Homecare. It would reduce access to DME and drive even more suppliers out of business. The president also calls for preapproval of power wheelchairs. That measure would strip $240 million from DME spending over 10 years, AAH notes. "This proposal heaps additional burdens on power wheelchair providers who are already reeling from severe reimbursement cuts," AAH says. The president's budget is just the opening salvo in the 2012 budget war, NAHC notes. Both parties in Congress will propose their own budget plans, and Republicans are expected to include steeper Medicare cuts in theirs, AAH says.