HME infighting imperils reform

Wednesday, September 2, 2009

WASHINGTON - There's a real concern among HME leaders that the industry may be blowing its chance to reform the Medicare oxygen benefit by failing to speak with a common voice.

"The world could be passing us by," Invacare Chairman and CEO Mal Mixon said last month. "I can tell our lobbyist to do something, but I don't know what to tell him."

NAIMES and CSIHME, as well as a few state and regional associations, have come out publicly against H.R. 3220, AAHomecare's plan to reform the oxygen benefit. The groups dislike several provisions in the bill, including one to remove oxygen from national competitive bidding (they feel that should be dealt with separately) and another to reclassify suppliers as providers.

The implications of reclassifying suppliers as providers are potentially dangerous to small HME providers, said NAIMES President and CEO Wayne Stanfield.

"That point is not negotiable," Stanfield said. "You are likely to see the gloves come off with this fight."

That's exactly what HME leaders fear will happen, and to a certain extent, has already happened.

NAIMES, CSIHME and a handful of consumer and clinical organizations sent a letter in July to Rep Mike Ross, D-Ark., the sponsor of H.R. 3220. The three-page letter stated that, "this legislation is fundamentally flawed--especially regarding adequate protection of patients and for clinical care."

"If I was Ross, I would say, 'Come back with something everyone agrees on,'" said one industry watcher. "He hasn't done that to his credit, but I wouldn't have the patience."

According to AAHomecare, Ross is "committed" to H.R. 3220. The bill is one of the more than 50 amendments that will be considered by the House Energy and Commerce Committee when it returns from recess in September. Ross told AAHomecare that he's committed to including the bill as part of healthcare reform legislation.

AAHomecare agrees there are some differences among patients, providers and clinicians on oxygen reform. The association will continue to work on a compromise and do everything it can to make sure oxygen reform is part of healthcare reform, said Walt Gorski, AAHomecare's vice president of government affairs.

"The real threat here is cuts to oxygen," he said. "And that is one of the key issues moving forward--to prevent those cuts from occurring."

As for the Senate: The Finance Committee hasn't released draft legislation yet, but industry watchers believe members may reduce payments for stationary concentrators and increasing payments for portable concentrators--something all industry stakeholders agree should happen. Members are also considering lifting the 36-month cap on reimbursement for oxygen.