Providers Descend on Washington

Drumming up more co-sponsors for H.R. 3790 at top of HMEs' agendas at AAHomecare Legislative Conference.

WASHINGTON, D.C. -- Nearly 300 providers converged on Capitol Hill today to attend the American Association's Washington Legislative Conference along with hundreds of meetings today and tomorrow with lawmakers and their staffs to lobby on behalf of the industry.

At the top of HMEs' agendas is the continued push to convince remaining hold-outs in the House to co-sponsor H.R. 3790, which calls for the repeal of CMS's national competitive bidding program. The bill to end NCB, introduced by Rep. Kendrick Meek (D.-Fla.) was up to 150 co-sponsors as of last night, when Rep. Phil Gingrey (R.-Ga.) announced at AAHomecare's pre-conference reception that he would co-sponsor H.R. 3790.

That said, the conference comes on the heels of President Obama's presentation of his plan for reforming U.S. healthcare, which includes the provisions from the Senate's healthcare reform bill that directly targeted the HME industry.

"Twelve months ago when we selected the date of this year's conference, we obviously had no way of knowing what the status would be of the ongoing congressional debate on healthcare reform," AAHomecare President Tyler Wilson told attendees at today's conference. "Well, we were fairly confident that the homecare community would still have concerns about competitive bidding, oxygen reimbursement, the first month purchase option for power wheelchairs, and no doubt other issues, we could not predict how the discussion about our issues would stack up timing-wise against all the other large healthcare questions that were being debated.

"So I can tell you, standing here on March 2, that you've come to Washington at a prefect time," he said, adding that the nation's healthcare is at a cross roads given the current push for far-reaching reform, such as those outlined in the President's proposal. "Almost everything related to healthcare is in play, and that means nearly everything is up for debate. And that, in simple terms, is good news and bad news for the homecare community."

Where that bad news is concerned, threats to homecare included in the President's reform proposal include:

  • Eliminating the first month purchase option for standard power wheelchairs (complex rehab PMDs would retain the option). Wilson said the option was in "real jeopardy and faces elimination," adding "we have a lot of work to do to prevent that option from being trampled if the large healthcare proposals in the House and Senate move forward."
  • Increasing the geographic coverage of Round Two of NCB to include 21 more competitive bidding areas.
  • Applying NCB prices nationwide to all HMEs by 2016.
  • Removing the 2 percent fee schedule increase for DME categories covered in the bidding. This increase was promised to providers per MIPPA in exchange for the delay to implementing Round One.
  • Requiring mandatory face-to-faces for all HME claims.
  • A productivity adjustment to the HME fee schedule that will annually lower payments by 1 to 1.5 percent.
  • An excise tax on manufacturers of DME, which Wilson noted could have "serious downstream repercussions on homecare providers."

On the positive side, Wilson said the industry is "in a good position to move the ball down the field" on primary issues, such as repealing competitive bidding via the Meek bill. He added that providers also had a "great opportunity" to make other gains in, particularly in protecting and reforming the oxygen benefit.

As part of their lobbying agenda for today and tomorrow, providers pushed for support of H.R. 2373, the HOPP Act, which was introduced by Rep. Tom Price (R-Ga.) and Heath Shuler (D-N.C.), which calls for ending the 36-month rental cap for oxygen equipment and restoring payments for the length of medical need.

Providers would also work to gain support for implementing other reforms to the oxygen benefit that were outlined by the industry last year. These included establishing a uniform level of service for patients; establishing retesting requirements; setting standards for home oxygen; conducting annual cost surveys of suppliers; outlining beneficiary "rights" regarding their level of information on treatment and other concerns, and choice of providers; and creation of a Home Oxygen Services Advisory Committee within HHS.

Weighing the opportunities and dangers facing providers, Wilson said that providers attending the conference should "find it reaffirming that you're hear in Washington at a pivotal moment in the nation's ongoing discussion about healthcare reform."

"We have a good story to tell, and can paint a positive picture with deep conviction, because it's both true and because it's confirmed by the people who receive homecare," he said, commending the audience for enduring the expense to travel to Washington to lobby on behalf of the industry. "The industry has to fight to protect its interests, and it has to stand up and push back when there is bad public policy coming out of Washington, D.C."

About the Author

David Kopf is the Editor of HME Business.

Comments

Mon, Mar 8, 2010 Sue Bailey

Just trying to get a clear understanding... From my understanding of the constitution medical issues are not the the federal governments responsibility. they are first of the family's responsibility and then the the local and then the state government. I think the federal gov't should get all the way out of the health care business. With all the various HC propositions we have seen from Senate, House and President of course I'd like the whole think stopped. If we have to pick at it one piece at a time, then #1 get rid of any provisions for killing the unborn. #2 Get rid of any provision that would prevent people from getting anything that our current laws say they are entitled to--especially high end DME that enables people to live a more normal life. Sue Bailey

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