Reform report leaves door 'wide open'

Tuesday, June 30, 2009

WASHINGTON--A Senate Finance Committee report released May 18 outlined options for financing healthcare reform and named HME reimbursement as a possible revenue source. But it did not propose specific cuts. 

The report, “Financing Comprehensive Health Care Reform: Proposed Health System Savings and Revenue Options,” has left industry stakeholders uncertain.

“They’ve left themselves wide open to do anything they want to do,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “They did this in every area of the report - leaving themselves options to cut whatever they want later on without locking themselves in to anything. That doesn’t give us a whole lot of comfort.”

The committee, which included in its report a section titled “More Appropriate Payment for Durable Medical Equipment,” plans to examine whether certain DME items are overpaid or underpaid. The Office of Inspector General (OIG) has identified items that it considers overpaid: oxygen, power wheelchairs and negative pressure wound therapy.

The report’s vagueness may not be such a bad thing, said Wayne Stanfield, president of the National Association of Independent Medical Equipment Suppliers (NAIMES). In 40 pages, it only mentions HME in three paragraphs, he pointed out.

“To me, (the reference to more appropriate payments for DME) seems to be an indication that the committee is going to look at HME more broadly,” Stanfield said. “For oxygen, for example, there needs to be some changes to reimbursement related to service.” 

The committee could decide that some DME items are underpaid, but providers shouldn’t hold their breath, industry stakeholders said.

“Concern has been raised that the 9.5% cut disproportionately harmed complex rehab, so that is one area that could be considered underpaid,” said Walt Gorski, vice president of government affairs for AAHomecare. “However, in this environment, it will be a tough sell to increase payments.”