Lions and tigers and bears. In Washington, the scary menagerie comes in the form of an omnibus bill. Some years it's larger than others, but the general principle is the same — Congress packages all of the measures it was unable to resolve into one single, often menacing bill at the end of the year to wrap up all of its business.
Often, industries breathe a sigh of relief as their issues fall off the radar screen during the long general congressional session, only to find that they suddenly reappear in the omnibus bill, which has happened in the past with home care issues.
In 2005, Congress packaged a bill, ultimately called the Deficit Reduction Act, that included capping oxygen rentals at 36 months and reduced the HME capped rental from 15 to 13 months. Last year, lawmakers combined tax, trade and health care provisions, and damaging home care provisions almost got swept up in the process.
And what about 2007? With the sustainable growth rate mechanism due to trigger a 10 percent cut in Medicare reimbursement for doctors, Congress faces intense pressure from physicians to find a way to offset this cut. Medicare HME has tended to be an offset of choice. Offsets to help doctors will most likely be bundled into the omnibus bill.
We believe a 2007 omnibus bill will be introduced after Thanksgiving and will include appropriations bills and possibly the State Children's Health Insurance Program as well. Because of the complexity of such legislation, and the Medicare package being perceived as having a smaller impact compared to the other issues, it will be difficult for members to vote against our provisions as they must consider so many other matters wrapped up in one congressional bill.
This type of legislation usually leads to party line voting. While President Bush has threatened a veto, the industry should still be preparing for battle. AAHomecare's mantra remains: Don't let fatigue settle in, and continue to fight the good fight. Contact Congress to reiterate the fact that approximately 8 million Americans require some type of medical care in the home, yet only 2 percent of the total Medicare budget is spent on home care. The services our industry provides have been recognized as “radically more efficient” than institutional care by U.S. Department of Health and Human Services Secretary Mike Leavitt — and are preferred by patients. Diminishing Medicare patients' standard of care by further reducing payments and services is shortsighted and unfair.
In the past 10 years, our industry has suffered as a result of competitive bidding and the DRA, and faces further cuts to oxygen and elimination of the first-month purchase option for power wheelchairs. Including further cuts to Medicare HME in a 2007 omnibus bill would be hitting home care before we've even begun to see how the previous years of cuts are going to affect us. And all of this is occurring at a time when pandemic flu and other national emergencies could force millions of Americans into home care.
Let's work together to build a grassroots effort that will demonstrate the urgency of our message. Encourage your members of Congress not to use home care to offset the cost of the “doc fix” and leave home care out of any omnibus legislation. Act now, because even one constituent can make a difference!
On the regulatory front, AAHomecare and representatives from several home care companies met in late October with Kerry Weems, the acting administrator of CMS. The discussion included fraud and abuse, power wheelchairs, oxygen therapy and competitive bidding. The group recommended several steps to CMS that would prevent Medicare fraud and efforts that would improve policies relating to power mobility devices.
Executives from Landauer Metropolitan, Pride Mobility, Blackburn's Physicians Pharmacy, The MED Group, Fuller Rehabilitation and the Power Mobility Coalition participated in the meeting, which was organized through the efforts of Pride Mobility working with Sen. Arlen Specter, R-Pa. As the ranking member of the Senate Appropriations subcommittee with jurisdiction over CMS, Sen. Specter's leadership in setting up the Weems meeting is a positive development in helping to ensure our concerns get a fair hearing at CMS.
Tyler J. Wilson is President and CEO of the American Association for Homecare headquartered in Alexandria, VA. Email tylerw@aahomecare.org. Or visit: www.aahomecare.org
