The House and Senate went home last week having both passed dramatically different versions of legislation that would reauthorize the state children’s health insurance program. The House attached wide-ranging Medicare-reform provisions to the legislation, among them the infamous 18-month oxygen-rental cap and a change that would eliminate the first month purchase option and force beneficiaries to rent power chairs for 13 months before ownership is transferred. The Senate steered clear of Medicare altogether.

Having thoroughly agitated large swaths of the HME community, the Congress went on vacation until after Labor Day.

When lawmakers return in September, a conference committee composed of members of the House Ways & Means, Energy & Commerce and the Senate Finance committees will try to reconcile the two houses’ versions. That will be the best opportunity for the industry to bring enough pressure to quash the oxygen and power-chair changes.

Despite the significance of the proposed oxygen and power chair changes, the major legislative wrangling will be over what the administration and congressional Republicans see as an expansion of Medicare in the House bill.

The House bill would, in fact, expand certain Medicare benefits and coverage, especially for low-income individuals. the president is expected to veto any bill that reaches the Oval office carrying Medicare-enlarging provisions. So, if industry pressure doesn’t strip the offending oxygen and power-chair sections, and if they survive in the bill that the conference committee sends back to the House and Senate for final votes, a presidential veto may put the issue out of its misery, at least for the time being.

Ironically, a veto could deprive the industry of what it needs to make a powerful case for robust Medicare support for medical oxygen. The House bill would require a government study that would assess the oxygen-related service and equipment now provided to Medicare beneficiaries. The assessment, which would be carried out under the direction of the Secretary of Health and Human Services (HHS), would evaluate the services that clients actually receive and whether they are “medically necessary or affect patient outcomes.” Many industry experts indicate that unlike the Morrison Study which proved the expense and validity of the services component of oxygen, an HHS-based study would be viewed as non-biased and could be more impactful in making the case for oxygen providers.