Senate makes Medicare moves

Sunday, June 8, 2008

WASHINGTON - Competing Democratic and Republican Medicare packages in the Senate could spell very different fates for the home medical equipment industry, according to industry sources.

Early this week, Sen. Max Baucus, D-Mont., chair of the Finance Committee, could bring a Medicare package to the floor that reduces reimbursement for home oxygen therapy and eliminates the first-month purchase option for standard power wheelchairs to help prevent a cut to physician rates from going into effect July 1, sources say.

Sen. Chuck Grassley, R-Iowa, a ranking member of the committee, could also introduce a Medicare package this week but without home medical equipment cuts, they say.

As of late last week, however, nothing was a done deal, industry sources said.

"The provisions included in the packages are still moving targets," said Walt Gorski, vice president of government affairs for AAHomecare.

To move forward, any Medicare package will need support from both sides of the aisle, industry sources pointed out. Right now, that's something Baucus doesn't have, they say.

"Baucus is still trying to figure out what permutations of provisions he can get support for from Republicans," said Cara Bachenheimer, senior vice president of government relations for Invacare. "It's very much in the negotiation stage."

In addition to excluding oxygen and power wheelchair cuts from the Medicare package, the industry seeks to include a delay to national competitive bidding. Late last week, the industry was scrambling to collect signatures for a bi-partisan letter to Baucus and Grassley from Sens. George Voinovich, R-Ohio, and Debbie Stabenow, D-Mich. The letter encourages the senators to "support legislation in the next few weeks to suspend implementation of this program until outstanding issues can be resolved."

The industry expects its efforts to delay competitive bidding to make progress early this week in the House of Representatives. Sources say Rep. Pete Stark, D-Calif., a member of the Ways and Means Committee, will introduce a bill that would delay Round 1 of the program for 18 months and Round 2 for one year after that. The bill would also require CMS to make improvements to the program.

Nearly one-third of the House (132 members) has signed a letter that urges Ways and Means Committee leadership to delay competitive bidding.

A Medicare package isn't necessarily the only vehicle for a delay, noted Seth Johnson, vice president of government affairs for Pride Mobility Products.

"We can't be hung up on the method," he said. "We need to continue to push Congress and let them figure out how to get it done, based on what's moving."