Home Health & Hospice Week

HME industry's MMA experience may rival agencies' BBA disaster.

If you were hoping for a bit of extra activity from the Centers for Medicare & Medicaid Services on non-essentials, you'd better think again.

Two former heads of CMS, one Republican and one Democrat, recently warned that the agency faces a huge task in implementing the sweeping changes contained in the recently passed Medicare Modernization Act.

In testimony before the Senate Governmental Affairs Committee April 8, Gail Wilensky and Nancy-Ann DeParle said the government should have contingency plans in place in case CMS misses deadlines in the legislation, which establishes a prescription-drug benefit for seniors beginning in 2006.

Wilensky was CMS administrator from 1990 to 1992 under the current president's father. DeParle's tenure ran from 1997 to 2000 under President Clinton, when the Balanced Budget Act of 1997 closed the doors of nearly a third of the industry's Medicare-certified home health agencies.

DeParle added that CMS must implement MMA, plus accomplish its normal duties, while facing a "brain drain" that has seen it lose more than half of its senior executive service staff since spring 2001.

Wilensky applauded the Senate for confirming new administrator Mark McClellan with unprecedented dispatch after Tom Scully's departure to the private sector. But DeParle cited the impending departure of Health and Human Services Secretary Tommy Thompson as another obstacle.

MMA may prove as deadly to the home medical equipment industry as the BBA did to home health agencies. The bill contains provisions slashing payment rates for oxygen and other HME-related drugs and a plan for national competitive bidding (see Eli's HCW, Vol. XII, No. 43).