Senate breaks without passing Medicare bill--or more cuts to HME

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Sunday, December 16, 2007

WASHINGTON – The Senate planned to break for the weekend late Friday afternoon without passing any Medicare legislation, sparing the HME industry from further reimbursement cuts for a few more days and possibly much longer, said industry sources.
As the year draws to a close, the Senate has worked furiously to pass a Medicare bill that eliminates a 10% reimbursement cut for doctors beginning Jan. 1. To help offset that, the Senate Finance Committee discussed cutting Medicare reimbursement for oxygen concentrators from $198 to $122 a month. Part of that reduction would be used to bump reimbursement for portable tanks and delivery--a more labor intensive process--from $35 to $77 a month. That means providers who supply a patient with a concentrator and portable oxygen would see their monthly reimbursement drop from $232 to $199. There would be no change in reimbursement for portable oxygen concentrators and transfilling concentrators. (It's unclear if the Senate would also propose eliminating the first month purchase option for power wheelchairs.)

It's looking more and more like that scenario won't play out, at least this year. As of Friday, Senate Finance Committee members were considering a small, non-controversial Medicare bill that would postpone for three to six months the scheduled physician reimbursement cut, said Cara Bachenheimer, Invacare's senior vice president of government relations. If that passes, it most likely will not include any HME reimbursement cuts, she said.

"If they do a mini doctor fix, if they feel politically inclined to help doctors again next year, they are going to be in there," Bachenheimer said. "From what we are hearing, 2008 is going to be an unusual year. Despite the elections, there could be a big Medicare package."

If that happens, there's a good chance lawmakers will look again at cutting oxygen reimbursement and eliminating the first month purchase option for power wheelchairs, say industry watchers.

Seth Johnson, Pride Mobility's vice president of government affairs, said he's heard from members of the Finance Committee that only a bare bones Medicare package can pass this year. Other members say that a bigger package could be hammered out.

"I think the odds are more in favor of doing something this year, even if it is a very scaled-back bill," Johnson said. "Continuing into next year gets complicated, especially rolling the physician fix back retroactively."

Ideally, lawmakers would like to craft a bill by Wednesday or Thursday and then break for the holidays, but they could work through Saturday, Dec. 22.

Whatever happens, "our work is not over until they pass a Medicare bill, and if they don't pass one this year, we're continuing to hear that they will absolutely come back and do something in late January or early February," Johnson said.

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