Home Health & Hospice Week

More payment changes loom for power wheelchairs, oxygen.

Watch out, Washington: Home medical equipment suppliers are choosing their battles--and there's a sure fight brewing over the feds' recent budget proposals.

Background: When President Bush released the budget blueprint Feb. 5, suppliers expressed dismay that the plan harbored bombs targeting HME spending (see Eli's HCW, Vol. XVI, No. 6).

In the weeks since, HME stakeholders have stepped up efforts to combat provisions in the administration's proposed budget for fiscal year 2008.

Topping the list of concerns are slashed Medi-care payments for most oxygen equipment and yet another change in Medicare policy for power wheelchair reimbursement. Congress Could Rethink Oxygen Caps The budget proposal suggests decreasing the allowable rental period for oxygen systems from 36 to 13 months--a threat to oxygen suppliers already struggling with reimbursement cuts (see Eli's HCW, Vol. XVI, No. 6).

And the Congressional Budget Office followed up with the same proposal in its "Budget Op-tions" report for 2008.

The change would take $500 million out of suppliers' pockets in 2008 and $3.5 billion over five years, CBO estimates.

Hidden benefit: But the proposal could turn out to be good news for suppliers hoping to persuade Congress to ditch the idea of oxygen capped rental. The budget doesn't expressly support continuing the new Medicare policy that requires seniors to assume ownership and responsibility for oxygen equipment after rental.

"The budget proposal's silence on this issue sends a clear signal to Congress that the [Bush] Admin-istration does not oppose reversal of the mandatory beneficiary ownership provision," notes a press release from the Elyria, OH-based oxygen supplier Invacare.

Change agent: The Home Oxygen Patient Protection Act (H.R. 621) would return Medicare policy for home oxygen therapy to the method in effect before the Deficit Reduction Act of 2005. The DRA forces patients to assume ownership of oxygen equipment after 36 months of use. Additional lawmakers have signed on in recent weeks to support the bill, bringing the total number of bipartisan cosponsors to 44. Keep Ownership An Option HME suppliers and manufacturers are also rallying against a budget proposal to eliminate an option that beneficiaries have now: to purchase a power wheelchair during their first month of use.

Background: The President's 2008 budget proposal calls for a new 13-month rental period for power wheelchairs, which would eliminate the first-month purchase option. Medicare, the administration argues, may be buying power wheelchairs for beneficiaries who need them for short periods of time.

Establishing a 13-month rental period for power wheelchairs would "ensure that Medicare and its beneficiaries no longer pay excessively for the purchase of equipment that could have been rented," the Department of Health and Human Services says in its budget summary.

Late in February, the American Association for Homecare's Rehab and [...]