WASHINGTON — Even as House of Representatives committees
began their markups of a health care reform bill last week,
providers and other oxygen stakeholders lobbied on Capitol Hill for
legislators to support H.R. 3220, the
Medicare Home Oxygen Therapy Act of 2009.
Introduced Wednesday by Rep. Mike Ross, D-Ark., the oxygen bill
— which, among other things, would repeal the 36-month cap
and remove oxygen from competitive bidding — comes at an
opportune time, according to Michael Reinemer, vice president,
communications and policy, for the American Association for
Homecare.
"The timing is good," Reinemer said. "The markup process has
begun in the House, so this is an ideal time to introduce an
amendment or try to work these provisions in in some fashion
… As quickly as [the health reform] process is moving, we are
still a long way from completing it," he said.
House leaders, working feverishly toward a vote before their
August recess, unveiled their bill on health care reform last week.
The bill passed the House Ways and Means and Education and Labor
committees but has run into resistance from the conservative Blue
Dog Democrats on the House Energy and Commerce Committee, which
also must sign off on the bill.
Ross, a former pharmacy/HME owner who chairs the Blue Dogs'
Health Care Task Force, told Congress
Daily last week he thinks the health reform bill has only
a 50 percent chance with the committee unless concerns over
spending are addressed. According to some Washington insiders, that
could give him the power to add amendments, including one that
would reform Medicare's oxygen benefit, to the bill.
Meanwhile, members of the National Emphysema/COPD
Association met with legislators Thursday to urge their support
of Ross' oxygen overhaul.
"Though it is extremely difficult for many users of home oxygen
to travel, patients and their families feel strongly enough about
home oxygen issues to visit Washington to share their personal
stories with their legislators and describe how home oxygen
improves quality of life for patients," said NECA President and CEO
Barbara Rogers.
The advocacy group told members of Congress the legislation
establishes a standard set of patient services, including routine
patient evaluations, patient monitoring, equipment training and
maintenance and emergency services, all of which play a crucial
role in ensuring oxygen users receive the medically appropriate
level of oxygen for health, safety and comfort.
"This legislation recognizes that home oxygen is much more than
a piece of oxygen equipment," NECA said in a press release
supporting the bill.
The National Home Oxygen Patient Association, American College
of Chest Physicians, and the National Association for Medical
Direction of Respiratory Care also support the bill, AAHomecare
reported.
Reinemer said the hope is the oxygen bill will draw the support
of at least the 69 representatives who signed on to an oxygen reform letter
circulated in June by Ross and Rep. Kendrick Meek, D-Fla.
View the full text of
H.R. 3220. See a summary of the Medicare Home
Oxygen Therapy Act of 2009 provisions courtesy Cara
Bachenheimer, senior vice president of government relations for
Invacare
Corp., in this issue.
Another oxygen proposal, the
Home Oxygen Patient Protection (HOPP) Act of 2009 (H.R. 2373)
also continues to gain support. Introduced in May by Reps. Tom
Price, R-Ga., and Heath Shuler, D-N.C., the bill would repeal the
36-month cap and restore oxygen payments for the period of medical
need. As of Friday, the HOPP bill had generated 70 cosponsors.
The Ross bill "certainly accomplishes the goal of the HOPP Act
since it repeals the cap," Reinemer said. "But there's much more to
be done with oxygen. Ross-Meek tries to make some more fundamental
changes so that we don't argue the same issues year after
year."
The bill isn't universally supported by the industry, however.
Members of the National Association of Independent
Medical Equipment Suppliers and CSI:HME sent Ross a letter outlining their
concerns with the bill, notably its move to "provider" (vs.
"supplier") status and cost-reporting measures. "It is the fear of
independent suppliers that a move to 'provider' status and a
mandate for cost reporting will be a stepping stone to moving
oxygen to a PPS program that will benefit larger companies," said
the letter, which was signed by 21 independent providers.
The letter also said the groups think linking oxygen reform to
removing the category from competitive bidding "may harm the
chances of reform being successful."
Whiff of Good News
As the health care reform debate moves forward, HME advocates are
also anxiously awaiting the Senate Finance Committee's health
reform proposal, where elimination of the first-month purchase
option for power wheelchairs — a provision that is included
in the House bill — could be on the table.
But according to Seth Johnson, vice president of government
affairs for Pride Mobility Corp., the power
mobility sector had some good news Friday.
"We are starting to hear that in the Senate, strong consumer and
clinician advocacy on behalf of the purchase option appears to be
softening the Senate's position," he said. "Now it is in question
whether it will be in the legislation, so we are encouraging
providers to make calls to their senators conveying the impact the
elimination of the first-month purchase option would have. We're
doing everything we can to keep this out of the Senate bill.
"If we are able to keep it out of this legislation, that would
keep it from popping up somewhere later this year," Johnson
continued. However, he noted, "There's no guarantee they wouldn't
come back a year or two from now and make a run at it again. It's
'Groundhog Day' on many of these issues … Many of these
battles are not new."
Stakeholders also got a whiff of more good news on Friday
regarding one of the industry's biggest recurring threats.
AAHomecare announced that, with other HME associations, it is
working to introduce legislation that would repeal DMEPOS
competitive bidding.
"Contact your representatives in the House to determine whether
they are willing to cosponsor legislation to eliminate the
anti-competitive program that will harm HME patients and
providers," the association urged in a Friday alert.
Names of those legislators interested in doing so should be
forwarded to Alex Bennewith at alexb@aahomecare.org, the
association said.
