WASHINGTON—Earlier today, the House
Tri-Committee—made up of the Ways and Means, Energy and
Commerce, and Education and Labor Committees—released an
updated draft of its massive health care reform bill.
While the bill—the American’s Affordable Health Choices
Act (H.R. 3200)—does not include additional cuts to oxygen,
it does require providers in month 27 of the 36-month cap period to
continue providing oxygen during the period of medical need through
the end of the equipment’s useful lifetime, regardless of the
patient’s location, unless another supplier accepts
responsibility.
As expected, the House bill also includes elimination of the
first-month purchase option for standard power wheelchairs,
although it maintains the option for Group 3 PWCs.
In addition, the updated draft exempts some pharmacies from
CMS’ DMEPOS surety bond and accreditation requirements and
increases the funding to fight fraud and abuse.
According to a Legislative Update from Waterloo, Iowa-based VGM
Group, the following is a summary of what analysts have cited so
far in the 1,018-page draft:
· Oxygen – No additional cuts to oxygen payments have been included. However, providers furnishing oxygen equipment at month 27 must continue to furnish the equipment, regardless of the patient’s location, during any subsequent period of medical need for the remainder of the reasonable useful lifetime of the equipment (60 months. Providers may furnish the equipment either directly or by making arrangements with other providers. In the case of a provider who has declared bankruptcy and has liquidated its assets, a new 36-month rental period with a new oxygen provider may begin if more than 24 months of rental payments have been made on the patient’s current rental period.
· Power Wheelchairs – The first-month purchase option for power wheelchairs will be eliminated for those in Groups 1 and 2, but complex rehab chairs in Group 3 or higher will not be affected.
· Surety Bonds – A pharmacy that has been enrolled as a DME provider, has had a provider number for at least five years and has never had an adverse action does not need to obtain a surety bond.
· Accreditation – A pharmacy enrolled as a DME provider, providing only diabetic testing supplies, canes and crutches does not need to apply for accreditation. Any provider that has submitted an application for accreditation before Aug. 1, 2009, will be deemed as meeting applicable standards and accreditation requirements unless the independent accreditation organization takes action on the provider’s application.
· Fraud and Abuse – The bill includes increased funding to fight fraud and abuse as well as enhanced penalties for fraudulent activities.
To view the entire bill, click here.
According to the American Association for Homecare, this version of the draft legislation is likely to be “marked up” (debated and/or amended) by the House committees later this week.
Both VGM and AAHomecare said they continue to review the
proposed legislation and will provide further analysis. Both
organizations are also urging providers to contact their federal
legislators about provisions in the measure as Congress continues
the debate on health care reform.
To contact your members of Congress, dial the U.S. Capitol
switchboard at 202/224-3121. The operator will connect you directly
to your legislator's office.
