Industry priorities have legs, but much work remains

Thursday, March 11, 2010

WASHINGTON – The House of Representatives could vote on healthcare reform legislation later this week, but with several HME-related provisions contained in the bill, it's OK with industry stakeholders if that doesn't happen.

"It's best if this thing does not pass," said John Gallagher, vice president of government relations for The VGM Group. "We are still mainly concerned with the escalation of national competitive bidding and the excise tax on manufacturers, which would only be passed on to the providers."

Also, the HME industry could use more time to build support to repeal competitive bidding. Significant headway has been made in the past two weeks: an additional 26 new cosponsors have signed onto H.R. 3790, the bill to repeal the program, for a total of 176. Several lawmakers have made "verbal commitments" to sign the bill, said stakeholders.

"This shows that when HME providers set their minds to a goal, we can achieve it," said Walt Gorski, vice president of government affairs for AAHomecare. "Clearly, you don’t get 176 without the facts being on your side. We have seen the best that CMS can offer to defend the program but at least 180 lawmakers have serious doubts."

The healthcare reform bill also contains a provision to eliminate the first-month purchase option for power wheelchairs and stakeholders are crossing their fingers that a budget-neutral alternative to preserve the option developed by Sen. Arlen Spector, D-Pa., could make its way into a reconciliation package.

"That alternative is not in the current Senate legislation but we are told that if enough representatives convey support to the Democratic leadership for its inclusion in the package that it could be included," said Seth Johnson, vice president of government affairs for Pride Mobility. "We are doing what we can to drum up grassroots support with those key Democrats that are noncommittal right now."

Additionally, more than a year after it was implemented, the industry may be ready to dust off efforts to repeal the 36-month cap on oxygen reimbursement. Although the Home Oxygen Patient Protection Act, introduced May 12 by Rep. Tom Price, R-Ga., has 86 cosponsors, industry stakeholders haven't been able to reach a consensus on how best to move forward. In February, AAHomecare released an issue paper on the bill, urging lawmakers to cosponsor it, with the "addition of key improvements to the home oxygen benefit, including linking reimbursement to beneficiary need and patient protections while sparing oxygen payments from further reduction."

The stumbling block is how to pay for a repeal of the cap without further burdening providers, who already took a 9.5% reimbursement cut in 2009, said Gorski.

"Even if you came up with a pay-for or an appropriate cost offset by reducing concentrator payments, the (worry) is that suppliers would shift their stationary-only patients to portable oxygen thereby increasing spending on oxygen," he said. "We need to address that issue before oxygen is able to move."