Bush tries again with HME cuts

WASHINGTON - As expected, the $2.9 trillion budget that President Bush delivered to Congress last week included a proposal to reduce the 36-month cap on Medicare oxygen reimbursement to 13 months. (See next story for more detail). The budget also included a proposal to eliminate the first-month purchase option for power wheelchairs. In a release, AAHomecare stated that the proposals, if enacted by Congress, would "heap new cuts" on an industry that has already weathered numerous other cuts and freezes in recent years. "Home care delivers value for every healthcare dollar and is clinically effective and preferred by patients and families," stated Tyler Wilson, president and CEO of the association. "These proposed cuts serve only to further hobble the homecare infrastructure that this nation desperately needs." Both proposals were included in Bush's budget for 2007, but neither was adopted by Congress. The National Home Oxygen Patients Association, the National Association for Medical Direction of Respiratory Care and the Council for Quality Respiratory Care also released statements opposing the proposal to reduce the oxygen cap to 13 months. The proposal, they all argue, is increasingly at odds with the clinical needs of oxygen patients, as well the ability of physicians and providers to deliver optimal home respiratory care. Because of the services needed to provide home oxygen therapy, patients are best served by a continuing, uninterrupted relationship with their providers, AAHomecare stated. Moreover, Congress has already reduced reimbursement for oxygen by nearly 50% over the past 10 years, the association pointed out. The proposal to eliminate the first month purchase option for power wheelchairs would reduce beneficiary access and increase costs, AAHomecare stated. In 2005, the U.S. Senate debated adopting the proposal, which would establish a 13-month rental period for chairs, but it failed to do so for the following reasons: * Beneficiaries who need power mobility devices suffer from long-term, debilitating conditions that are not short-term in nature. * Many power wheelchairs are custom-configured and individualized for the patient. These are not commodity items. * Eliminating the first-month purchase option would severely curtail beneficiary access, as the supplier will be unable to cover the significant up-front service costs that go into providing the most appropriate power wheelchair to accommodate the beneficiary's needs. * More than 95% of all power wheelchairs are purchased in the first month because beneficiaries who meet the coverage criteria have long-term life needs.