HME fight against Medicare reform takes turn for worse

Sunday, November 23, 2003

November 24, 2003

WASHINGTON - The threat of competitive bidding, a CPI freeze and imminent cuts to bread and butter HME products turned vastly more ominous in the wee hours of Saturday morning when the House of Representatives voted to pass Medicare reform legislation by a vote of 220 to 215.

The Senate is expected to vote on the measure this evening. The New York Times was reporting late this afternoon that preliminary tallies indicate that the Senate will pass the legislation.

The House vote turned on an extraordinary display of political arm-twisting as the bill’s boosters overturned an initial vote of 218 to 216 against the measure into a five-vote victory during a three-hour long roll call. That roll call is the longest in the history of the House of Representatives.

Among those voting in favor of the bill was the Ohio Republican, David Hobson, who made headlines earlier this month with his staunch opposition to the bill’s competitive bidding provision. His defection has staggered his supporters in Ohio.

“He threw himself from the bus for us last week,” said Kam Yuricich, director of the Ohio Association of Medical Equipment Services (OAMES). “He was the guy who was willing to do the unfavorable, politically courageous thing, but then the minute before midnight whatever happened is beyond me.”

What happened after midnight is grim news indeed for HME providers. Included in the Medicare reform bill are provisions that would freeze the DME CPI update for five years; roll out competitive bidding in the 10 largest MSAs in 2007; and cut reimbursement on a slew of HME products in 2005.

The industry’s next best chance is playing itself out this afternoon as HME industry players drive home the negative aspects of the bill to their legislators.

"It looks tough at this moment, but we still have a chance,” said AAHomecare President Kay Cox. “The senate has not passed this bill, and that is our main focus."

Like Hobson, erstwhile industry champions such as Sen. Mary Landrieu, D-La., and Sen. Dianne Feinstein, D-Calif. have announced that they would support the bill. Landrieu and her opposition to competitive bidding were featured in a CQ article two weeks ago.

Sen. John “Breaux, D-La., must have been putting some pressure on her,” speculated John Gallagher, vice president of government relations at the VGM Group. Breaux was one of only two Democrats on the conference committee that reconciled House and Senate versions of Medicare reform. “Now Landrieu, Hobson, Feinstein, they’re all gone.”

In Pennsylvania, the industry had hoped Republican Sen. Arlen Specter would hold the line against competitive bidding.

“Specter wrote a letter that said he supported a CPI freeze as a way to get some savings out of our industry,” said Bill Bayer, director of client services at Medical Express in Bristol, Pa. “But now the language is in there, and they are probably going to vote along party lines.”

The momentum against the reform took a huge hit last week when the AARP endorsed the measure. The American Medical Association, the American Hospital Association and long list of other professional associations supported the legislation. The AFL-CIO has stated its opposition.