FEHBP cuts: Here they come

Sunday, December 12, 2004

December 13, 2004

WASHINGTON - A full court press by the HME industry to repeal Medicare reimbursement cuts based on Federal Employees Health Benefit Plans (FEHBP) appears headed for certain failure.
Industry leaders are resigned that legislation (H.R. 4491) that would have repealed the cuts, scheduled to go into effect next month, will not pass this year. Nor will CMS delay implementing the FEHBP cuts to key items of DME, including nebulizers  (a 14% reduction), power wheelchairs (3%) and concentrators (11%).
Industry leaders acknowledge that the defeat is disappointing, but they also point out that 117 of 435 representatives signed on as co-sponsors of H.R. 4491. That is a tremendous show of support and those relationships should benefit the industry in future dealings with CMS, they say
“That is a huge good news story,” said Cara Bachenheimer, vice president of government relations for Invacare. “I can’t remember the last time this industry was so successful in garnering support from that many members of Congress.”
H.R. 4491 failed because, in the end, there was no larger piece of legislation to attach it to. Likewise, despite congressional support, CMS must follow the law and implement the cuts, Bachenheimer said.
At AAHomecare, the goal in 2005 is to bring back H.R. 4491 as quickly as possible, said Chairman Tim Pontius.
In arguing against the cuts, the industry pointed out that comparisons between FEHBP plans and Medicare are invalid because Medicare beneficiaries are, in general, older and sicker.
“It’s bad policy and we need to get 4491 back on the docket,” Pontius said. “We need to get this thing out of there and sit down and revisit what is a more appropriate way to compare Medicare with other payers.”