Home Health & Hospice Week

Bidding remains biggest home care specter.

Home care industry members are congratulating one another on dodging the copay bullet, but the move may be moot now that negotiations on the legislation have bogged down again.

The House and Senate lawmakers working out the differences between their respective bills on Medicare have agreed to oust home health copayments from the legislation and institute a one-year rural add-on (see Eli's HCW, Vol. XII, No. 39, p. 308).

But that would come at a price - a 0.9 percent reduction to reimbursement updates for inflation. The cut to the HHA market basket index update would last three years and start in April 2003, trade associations report.

Still up for debate at press time was the possibility of competitive bidding for durable medical equipment. A combination of an inflation update freeze and institution of DME competitive bidding seems to be most popular proposal, the American Association for Homecare reports.

No changes at all might be the result despite months of negotiations, as the outlook for the negotiation process dims once again. Conferees can't seem to get past some controversial issues with the prescription drug benefit, which is wrapped up in the overall Medicare bill. "It is unclear whether or not the bill will be signed into law since there are a number of politically contentious issues in play," notes the National Association for Home Care & Hospice.

And Democrats continue to protest that they are being left out of the negotiation process nearly altogether. Even if the conference committee finally hammers out a bill, it's looking less and less likely that it will pass the whole Senate and House.