Home Health & Hospice Week

Proposal would also axe beneficiaries' extended rental option.

Durable medical equipment providers once again are fighting a financial threat from the federal government. This time it's a Senate plan to kill the semi-annual maintenance payment for capped rental equipment and to eliminate the extended rental option.

Currently, suppliers must give Medicare beneficiaries the option of purchasing certain items such as hospital beds after 10 months of renting. If beneficiaries choose to buy, Medicare continues to make rental payments for three more months and then the supplier transfers the equipment title to the patients. If they choose to rent, the supplier maintains ownership, and Medicare makes rental payments for up to five more months.

In an effort to trim Medicare spending, the Senate's budget reconciliation legislation would require the title for certain DME to be transferred to the beneficiaries after a 13-month rental. It would also eliminate the regular twice-yearly payments made for servicing and maintenance and move the option for beneficiaries to purchase power wheelchairs from the time they're initially furnished to the 10th month.

Section 6109 of the Senate proposal implements the recommendation from a 2002 report by the HHS Office of Inspector General that called for eliminating the maintenance payment for capped rental equipment and to pay for repairs only when needed.

Payments to suppliers for maintenance, servicing of parts and labor not covered under warranty would be made if the Department of Health & Human Services determines those payments are reasonable and necessary. HHS would also determine the amount of such payments.

Plan Burdensome To Patients The Washington-based American Association for Homecare sent a letter to Senate Finance Committee Chair Sen. Charles Grassley (R-IA) and Ranking Member Sen. Max Baucus (D-MT) opposing the change, highlighting its impact on beneficiaries.

"Shifting the responsibility for maintaining often complex medical equipment from the provider to the elderly or disabled Medicare beneficiary who needs this equipment is unfair and potentially dangerous," AAHomecare President and CEO Kay Cox says in the Oct. 24 letter.

The majority of patients choose to rent rather than buy, the letter points out. Placing responsibility for repairs and maintenance on patients in rural areas would be especially problematic, Cox notes.

While there may be items that should not be categorized as capped rentals, they should be chosen carefully, Cox adds.

Take action: Providers should contact their representatives and voice their concerns about the Senate proposal, AAHomecare urges.