The American Association for Homecare sent a letter to theSenate Finance Committee (at the committee’s request) outlining concerns about its list of options for financing health reform through Medicare cuts.

The Senate Finance list targets Medicare payments for home medical equipment for potential reimbursement reductions but does not propose specific cuts to HME.  Section I of the document, “Health System Savings,” discusses options for “ensuring appropriate payment,” and one subsection, “More Appropriate Payment for Durable Medical Equipment,” cites the Office of Inspector General at the HHS as saying that fees for certain DME items are overpriced.

On April 22, Inspector General Lewis Morris told the Senate Homeland Security subcommittee on Federal Financial Management that “Prior OIG work also has found that Medicare pays too much for certain pieces of DMEPOS and related supplies, such as power wheelchairs, hospital beds, diabetic supplies, and home oxygen equipment.”

In this week’s six-page letter, AAHomecare reiterated that the HME sector has been subjected to a long series of deep and disproportionate reductions in Medicare reimbursements in recent years. It said those cuts are having a negative impact on the quality of care that Medicare beneficiaries and physicians alike have come to expect.  

The letter, sent to committee Chairman Max Baucus (D-Mont.)and Ranking Member Charles Grassley (R-Iowa), recommended the following actions:

• Refrain from further cuts to oxygen and enact budget-neutral reform to improve quality of care and increase cost transparency.

• End the “competitive” bidding program, which is a flawed administrative pricing mechanism that produces arbitrary and capricious pricing that will reduce access to care and put thousands of small providers out of business.

• Restore appropriate payment for complex rehab to preserve beneficiary independence.

• Enact effective and aggressive fraud and abuse measures that focus on preventing and detecting Medicare fraud early, which is a more proactive approach than the current “pay and chase” system of combating fraud.