Home Health & Hospice Week

Congressional leaders set Oct. 17 deadline for Medicare legislation.

The final word on Medicare legislation might be just around the corner, and it could mean the world to your organization. Republican leaders in the House and Senate have chosen Oct. 17 as the zero-hour for the compromise legislation regarding the prescription drug benefit and other Medicare-related issues, including home care provisions. The issue also gained momentum when President Bush had a face-to-face meeting with the House and Senate conferees working on the compromise legislation. The President urged them to finish work on the bill, which requires ironing out the details between the House and Senate versions of the legislation (H.R. 1 and S. 1, respectively). Although the legislation contains many provisions that could affect home care providers, there are three core proposals that would most impact home health agencies, says the National Association for Home Care & Hospice: a copayment for home health episodes, a cut to inflation updates, and a restoration of the 10 percent add-on for rural HHAs. The copay and inflation cut would negatively affect agencies and their patients, while the add-on would be a big plus for rural HHAs struggling to stay afloat (see pf of Eli's HCW, Vol. XII, No. 32, p. 250). Durable medical equipment suppliers' main issue is a proposal in the House bill to implement competitive bidding for DME. The Senate calls for a seven-year freeze on inflation updates instead, a better but still undesirable alternative. Respiratory companies, infusion providers and pharmacies are worried about average wholesale price-related proposals, which would cut reimbursement to the bone for drugs such as the nebulizer medication albuterol sulfate. The fate of the HHA priorities is looking up, judges William Dombi, vice president for law with NAHC's Center for Health Care Law. Although House reps appear to be standing strong on the issue of imposing home health copays, a majority of senators have offered a helping hand. Sens. Susan Collins (R-ME), Kit Bond (R-MO), Jack Reed (D-RI) and Russ Feingold (D-WI) submitted a "Dear Colleague" letter to Medicare conferees, urging them to adopt the home care provisions in the Senate bill - no copay, no inflation cuts and reinstitution of the rural add-on. Fifty-seven senators signed on to the letter, which is "a potent number," Dombi notes. The letter "will help regarding home health issues," agrees Kathy Thompson with the Visiting Nurse Associations of America. Home care providers and their patients also have gotten proactive about contacting their congressional representatives to urge no copay, Dombi says. Congressional offices report hearing much more on this issue than just a few weeks ago. Some lawmakers also are rallying around DME suppliers' concerns. Rep. Dan Burton (R-IN) sent a Sept. [...]