Home Care Members Take Their Voices to Capitol Hill

By Sandra L. Bienkowski

Approximately 81 companies and 131 attendees spoke up for home care at the American Association for Homecare's (AAHomecare) Legislative Fly-In on Capitol Hill June 19 and 20.

Home Oxygen Patient Technology Fair: Simultaneously occurring while HME providers and manufacturers lobbied, the Home Oxygen Patient Technology Fair allowed members of Congress and their staff to see firsthand how home oxygen consumers use their technology. Respiratory manufacturers were on hand to display and demonstrate equipment while patients and clinicians were available to discuss quality of life and therapeutic benefits.

Two legislative issues took center stage in a day-long lobbying effort June 20: H.R. 5513, The Home Oxygen Patient Protection Act, and H.R. 3559, the Hobson-Tanner Bill.

Introduced by Congressman and physician Joe Schwarz (R-Mich.), The Home Oxygen Patient Protection Act would restore oxygen reimbursement to the way it was prior to the Deficit Reduction Act (DRA) of 2005, eliminating the capped rental at 36 months that severs the critical relationship between provider and patient and makes beneficiaries assume ownership of the equipment.

The DRA includes a provision that industry lobbyists say "forces ownership" for medical oxygen equipment after 36 months to patients.

"This isn't rent-to-purchase. The Centers for Medicare and Medicaid Services (CMS) makes it sound like apple pie. This is forced purchase," said Tom Ryan, chairman of AAHomecare and president/CEO Homecare Concepts Inc.

Congressman Schwarz was keynote speaker at AAHomecare's breakfast and send-off before marching to Capitol Hill.

"The attitude of rent-to-own bothered me a great deal. I can't imagine where this concept came from," Schwarz said. "This forces oxygen patients — some elderly who have trouble taking care of themselves — to take care of their own equipment. We have to delete the language in this provision," Schwarz said.

H.R. 5513 seeks to maintain the relationship and service component between patient and provider of home oxygen therapy; make congressional officials aware of the cost and importance of service; as well as convey patient safety issues of transferring ownership to the beneficiary, considering that oxygen is a prescribed form of medication.

Jokingly referring to the bills in Washington moving at "the speed of a tortoise … actually a dead tortoise," Schwarz promised to do his very best to get H.R. 5513 to move, possibly in the next session of Congress, the 110th session.

"This is one of those pieces of good government that will get through. You have my commitment," he said.

Attendees separated by table into state teams at the morning's send-off breakfast, and each team received a list of appointments with senators, representatives and legislative counsel for their particular state.

"We can win this if we commit to action. Let's put our boots on the ground and march to the Hill," Ryan said.

The second issue that lobbyists took to the Hill was H.R. 3559, the Hobson-Tanner Bill, designed to ease the pain of competitive bidding.

Who's Who? Invacare sponsored the Homecare PAC Reception to kick off the Legislative Fly-In, while Respironics sponsored the Capitol Hill Reception at the conclusion of lobbying.

H.R. 3559 seeks to:

  • Protect patients by requiring that competitive bidding not begin until quality standards are in place
  • Exempt smaller, rural areas (Metropolitan Statistical Areas with populations under 500,000)
  • Restore the rights of participating providers to administrative and judicial review
  • Exempt items and services unless savings of at least 10 percent can be demonstrated.

Speaking to U.S. Representative Jeb Hensarling (R-5th), Colin Fairley, owner of Adapt Mobility, Garland, Texas, said, "Instead of creating competition, competitive bidding — the way it is now — will create a monopoly and it will hurt the service component of the business if one or two providers exclusively have to take care of a wide area."

Rep. Hensarling indicated that he would review the bills as outlined by AAHomecare in a legislative packet in order to determine if he'd lend his support.

Other issues lobbied for included:

  • Improving the method for setting the power mobility fee schedule
  • Exempting power chairs from competitive bidding
  • Monitoring the 61 new power mobility codes to ensure access to medically appropriate equipment

Although the impact home care lobbyists had on the Hill is yet to be seen, Ryan expressed his disappointment with the turnout. "This is not right. Ask other people you know why they were not here," Ryan said.

HMEs Watch Role-Playing to Learn Lobbying Technique

HMEs Watch Role-Playing to Learn Lobbying Technique

In a somewhat humorous display, Cara Bachenheimer, government affairs specialist for Invacare, led role-playing in order to give providers and other industry advocates a quick tutorial on how to lobby. Wayne Grau, with Pride Mobility; Todd Brason, with Willcare; and Lisa Getson, with Apria; all participated. Playing the role of senator was Michael Reinemer, vice president of communications and policy at AAHomecare.

If you take your voice to Washington, here are some tips Bachenheimer offered:

  • Be succinct.
  • Only chitchat for one minute.
  • *When your butt is in the chair, get down to business.
  • Designate one person per issue.
  • Gauge knowledge of staffer if you aren't meeting directly with the representative or senator but respect the staffer.
  • Get close to aide or staffer, they are the ones who have the time to know the issues.
  • Demonstrate how many people you touch, how many constituents you reach.
  • Let them see you as a great resource for information.
  • Don't talk in CMS jargon and acronyms. "They could think OCD is over the counter drugs, not oxygen conserving device."
  • Use the word "provider" not "dealer."
  • Don't be angry if the representative or senator questions a bill or its components. Be rational.
  • Close the sale. Ask for what you want. Example: Sign on the Hobson-Tanner Bill.
  • Get a business card and follow up. The squeaky wheel gets the grease. Send an e-mail, leave a message on the phone or send a fax. Don't mail a letter because the Anthrax scare has slowed the process down. It takes forever to arrive, and it doesn't look like a letter once it does.

This article originally appeared in the June 2006 issue of HME Business.

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