The Senta Fianance Committee began debating a “framework” health reform document his week that would cut Medicare reimbursement for HME and implement an excise tax on medical device manufacturers. The reductions and new fees proposed by the Senate Finance Framework are aimed at medical oxygen therapy, power wheelchairs, and the broader home medical equipment sector generally.
The document, issued by Chairman Max Baucus (D-Mont.) over the weekend, can be found in the “What’s New” section of www.aahomecare.org. There are at least three sections of the 18-page framework that deal with HME policty, according to AAHomecare. The text of those sections:
Oxygen Payment Improvements. This provision would repeal the 36-month rental cap, reduce the current rental amount paid through the fee schedule for stationary equipment and contents, and increase the rental amount paid through the fee schedule for portable oxygen contents.
Power Wheelchair Payment Improvement. This provision would eliminate the option for a wheelchair supplier to purchase a power-driven wheelchair with a lump-sum payment (except for complex, rehabilitative power wheelchairs).
Durable Medical Equipment Outlier Payment Rule. This provision would reduce payments in non-competitive-bidding metropolitan statistical areas (MSAs) with spending levels that exceed a benchmark of 110 percentof the national average. MSAs above the benchmark would have payment rates reduced by an amount equal to 75 percent of the difference between its spending and the benchmark.
The framework is not a final product and Senate Finance negotiators might modify it or make alternate provisions. However, Baucus says any members suggesting modifications that would result in an increase in the package’s cost should offer offsets to ensure the healthcare package remains budget-neutral.
“The American Association for Homecare is disappointed that the Senate Finance Committee ‘framework’ circulated earlier this week by Chairman Baucus would target the durable medical equipment sector for further cuts under Medicare,” said AAHomecare President and CEO Tyler Wilson. “Reductions in Medicare reimbursement, curbs on inflation ‘updates,’ and excise taxes are bad medicine for a sector that is already struggling due to past actions by Congress.
“Congress should note that this sector has endured numerous cuts in recent years, notably with the Medicare Modernization Act of 2003, the Deficit Reduction Act of 2005, and the Medicare Improvements for Patients and Providers Act of 2008,” Wilson continued. “As a result of these reductions, power wheelchair reimbursements have declined more than 35 percent in the past five years and oxygen reimbursement has declined by nearly 50 percent over the past decade.”
Tyler noted that spending growth in HME is less than one percent per year according to the most recent National Health Expenditures data. “Senate Finance is proposing cuts to the most cost-effective sector in Medicare,” he said.