Competitive bidding delay close to reality

Sunday, July 13, 2008

WASHINGTON - The home medical equipment industry remained cautiously optimistic last week that, even if the president vetoes a Medicare bill that would delay national competitive bidding, there are enough votes in the Senate and the House of Representatives to override him.

"The message is still, 'Keep the pressure on,'" said Cara Bachenheimer, senior vice president of government relations for Invacare. "But we're in a good position."

The Senate voted 69-30 to pass the bill on July 9, and the House passed it 355-59 on June 24. Both are veto-proof margins.

There are concerns, however, that the president will veto the bill and then pressure Senate Republicans to change their votes. Nine Republican senators who voted against the bill June 26 voted for it July 9. The president would need to sway only three Republican senators to preserve his veto.

The House, with such a wide margin, is a "slam dunk," said one industry source.

Anything's possible, but industry sources don't expect senators to change their votes.

"I don't see what the president could offer Republican senators to change their votes," said Seth Johnson, vice president of government affairs for Pride Mobility Products. "With a make-or-break election for many of them this fall, they have too much at stake."

With a 10.6% cut to physician reimbursement scheduled to go into effect July 15, the industry expected the president to sign or veto the bill Friday or over the weekend. The bill blocks those cuts, instead implementing cuts to Medicare Advantage, a private program the president and some Republican senators want to protect.

The bill would then go back to the House and the Senate for votes on Tuesday and Wednesday, sources say.

The president could also take no action on the bill, meaning it becomes law in 10 days.

Reports in The Hill, a beltway newsletter, seem to support the belief that an override is imminent. "Considering the numbers in both chambers, I don't think it's going to be much of a surprise that it would be overridden," a legislative aide told the publication. Sen. Harry Reid, D-Nev., the Senate majority leader, told The Hill: "The writing's on the wall."

The physician industry and Medicare beneficiaries have pressured senators to pass the bill.

Last week, AAHomecare was working the phone lines.

"We've already had a call with our state leaders," said Michael Reinemer, vice president of communication and policy. "We're trying to keep this bill alive."