Industry: HME safe--for now

Sunday, September 23, 2007

WASHINGTON - It appears that lawmakers have decided not to include any cuts to Medicare, including home medical equipment, to help fund a $35-billion expansion of the State Children's Health Insurance Program (SCHIP), say industry watchers.

That doesn't mean, however, that providers are off the hook. Legislators must still come up with a way to avoid cutting physician reimbursement by 10% (billions of dollars) on Jan. 1, 2008. To do that, everything is on the table, including eliminating the first-month purchase option for power wheelchairs and reducing the 36-month cap on Medicare oxygen reimbursement, said Cara Bachenheimer, Invacare's senior vice president of government relations.

"We are not in the best position that we could be in," said Walt Gorski, AAHomecare's vice president of government affairs. "Both the House and the Administration support (HME) provisions that will harm patients and providers."

Additionally, if lawmakers add other provisions to the Medicare legislation, such as increased spending on rural health care, the danger that HME cuts will be targeted to help offset the spending escalates, say industry watchers.

In concocting a "physician fix," lawmakers have the added pressure of wanting to craft a plan that covers at least two years. That way they won't have to revisit this issue during an election year (2008) and anger providers by taking more money away from them, Gorski said.

"It's probably going to be a long October and November in Washington," Bachenheimer said. "We need to make sure we stay off the list."

Gorski echoed that sentiment: "We've got an awful lot of work to do."

To improve the industry's chances, it's crucial that providers take part in grassroots lobbying efforts, Bachenheimer said.

Legislators plan to pay for the new SCHIP spending by raising the tax on tobacco. It's almost a certainty that President Bush, who does not want to expand the program, will veto the bill.