Industry pulls out all the stops

WASHINGTON - The industry embarked in January on a last-ditch grassroots effort to convince legislators to vote against a proposal to cap oxygen at 36 months and transfer title of the equipment to the beneficiary at that time. "It's not going to be easy," said AAHomecare Chairman Tom Ryan. "It's going to be a little bit like pushing a snowball up a hill." Unfortunately, the industry has no choice. In December, the House and Senate voted for a deficit reduction bill that included the cap on oxygen (inserted at the last minute without industry input) and eliminated the cap rental option for DME. The changes will reduce Medicare expenditures for DME by $750 million over five years. (It could have been much worse. Originally, Rep. Bill Thomas, R-Calif., proposed capping oxygen reimbursement at 18 months. Invacare and Apria lobbied hard to eliminate the cap and ultimately Thomas compromised at 36 months.) Because the Senate made some minor changes in the final bill, House members must vote on it again and were expected to do so in early to mid-February, following their return from the holiday break. "You can guarantee that Bush, during his State of the Union speech Jan. 31, will talk about fiscal responsibility and the need for Congress to pass this deficit reduction bill," Ryan said. "He'll put the calls out to his party and they will probably vote on it the next day." With such a short timeframe to work with, state associations have begun marshalling members to reach out to beneficiaries and encouraging them to contact their congressmen and urging those who voted for the bill to vote against it the second time. In an election year, congressman will pay attention to unhappy constituents, say industry insiders. "For the first time in my experience in the industry, we are seeing much more involvement from beneficiaries," said Karyn Estrella, executive director of the New England Medical Equipment Dealers (NEMED). "This issue really seems to be sparking a lot of interest in concern." That concern revolves around beneficiaries taking ownership of their equipment following the 36-month cap period. When that happens, who will maintain the equipment? Providers wonder. Who will fix the concentrator if something goes wrong? While it's a long shot that the House will reverse its vote, industry leaders intend to spearhead the charge to make it happen. "This is a defining moment for the industry," Ryan said. "It is an opportunity to have the largest grassroots campaign ever. And the issue is patient safety, not the profitability of the oxygen provider."