FEHBP cuts: Here they come

Friday, December 31, 2004

WASHINGTON - A full court press by the HME industry to repeal Medicare reimbursement cuts based on Federal Employees Health Benefit Plans (FEHBP) appeared headed for certain failure last month.

Industry leaders acknowledged that legislation (H.R. 4491) intended to repealed the cuts - scheduled to go into effect this month - would not pass in 2004. They’d also given up hope that CMS might delay implementing the FEHBP cuts to key items of DME, including nebulizers (a 14% reduction) and concentrators (11%).

Industry leaders called the defeat disappointing, but they also pointed out that 117 of 435 representative 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 point 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.”