Home Health & Hospice Week

House, Senate wrestle with Medicare cuts.

There's a fight brewing in Congress--and suppliers of home medical equipment will be wise not to sit on the sidelines, insiders say.

Some good, old-fashioned grassroots political action is likely what it will take to save you from new cuts in Medicare reimbursement for power mobility devices and oxygen and related supplies.

What's happened: In the first days of August, the House and then the Senate approved companion bills aimed at reauthorizing the State Children's Health Insurance Program (SCHIP) and creating a permanent physician payment fix.

The House bill, the Children's Health and Medicare Protection Act of 2007 (H.R. 3162), is a five-year, $50 billion SCHIP reauthorization that also includes myriad Medicare "reform" measures (see Eli's HCW, Vol. XVI, No. 27). Passed Aug. 1, the bill includes a new layer of reimbursement cuts for suppliers of power mobility devices and oxygen and related supplies.

Expect Quick Turnaround

Specifically, the House bill calls for a 13-month capped rental on oxygen, steep cuts to oxygen reimbursement rates and elimination of the first-month purchase option for power wheelchairs, reports the American Association for Homecare.

The Senate version (S. 976), passed Aug. 2, would reauthorize SCHIP at $35 billion over five years--without the extra baggage of Medicare payment policy changes.

What's next: When Congress reconvenes after Labor Day, the lawmakers will be faced with reconciling the big differences between the two bills--fast. Without quick action to reauthorize SCHIP, the program will expire at the end of September. That timeframe makes it anyone's guess how the legislation will wind up affecting home medical equipment providers.

"It's very difficult to speculate about what will emerge from the conference committee to reconcile the two bills," says Wayne Stanfield of the National Association of Independent Medical Equipment Suppliers (NAIMES) in Halifax, VA, noting that the House's decision to include the cuts for oxygen and PMDs is politically "bad news."

Both the House and Senate bills take a "pay as you go" approach to refunding SCHIP, but the Senate opted to find more funding by way of a 61-cent tobacco tax increase.

Political pressure in the House led legislators to go easy on the tobacco industry, says Stanfield--at the expense of patients with COPD.

"Rather than raise tobacco tax and reduce health care costs, they've chosen to take a swipe at over a half a million oxygen patients--and a swipe at the providers who serve them," he says.

Congress has reduced Medicare reimbursement for oxygen therapy by nearly 50 percent over the past 10 years, notes AAHomecare.

Best hope: It's up to HME providers and consumers they serve to make the proposed cuts as controversial as possible, advises Eric Sokol of the Power Mobility Coalition, in Washington, DC. The Senate, he says, will be seeking to send the narrowest bill possible to President Bush, who has vowed to veto any SCHIP reauthorization but who would presumably be more open to a less expansive bill.

Don't delay: Insiders tell Eli that it's likely that congressional staff will meet informally during recess, making it vital that the HME stakeholders contact legislators now.

"I hope providers will rally," says Stanfield.

Resources: Both NAIMES and the Power Mobility Coalition offer "talking points" tip sheets designed to inform correspondence to representatives. Go to www.dmehelp.org (for NAIMES) and www.pmcoalition.org.