AAHomecare Vows Fight on Health Reform Provisions

ARLNGTON, Va. — In a statement issued yesterday, the
American Association for Homecare said it will continue to fight
provisions in health care reform legislation that would have a
negative impact on HME. President Barack Obama is set to sign the
sweeping reform bill into law in a White House ceremony today.

Following Senate passage of the bill on Dec. 24, 2009, the House
passed the Senate
measure late Sunday night along with a reconciliation
bill that would “fix” some House members’ concerns with the
package.

“Unfortunately, this health reform bill contains several
provisions that will disproportionately hurt home care providers
and home care patients,” said AAHomecare President Tyler
Wilson.

“The bill accelerates the controversial ‘competitive’ bidding
program for durable medical equipment, which simply creates a race
to the bottom in term of quality of care for Medicare seniors and
people with disabilities. The misguided bid program will actually
reduce competition by putting most providers out of business, even
if they agree to rock-bottom reimbursements,” Wilson said.

He added that the health care bill “also eliminates the option
that Medicare beneficiaries currently have to purchase power
wheelchairs as soon as needed instead of renting them.”

Here’s the association’s rundown of final health care reform
provisions that directly impact HME providers:

• Expands Round 2 of competitive bidding by an
  additional 21 metropolitan statistical areas.
• Competitive bidding pricing must be implemented in every MSA by
  2016.
• Eliminates the 2 percent increase for Round 1 competitive
  bidding items in 2014.
• Eliminates the first-month purchase option for standard power
  wheelchairs.
• Requires a mandatory compliance program for all providers,
  including HME providers.
• Imposes an excise tax on medical device manufacturers ($20
  billion over 10 years).
• Requires a face-to-face exam for all HME and home health items
  and services.
• Includes a yet-to-be-defined “productivity adjustment” that
  would lower future CPI-Urban updates to the HME fee schedule. We
  believe that this would lower the annual HME update by about 1
  percentage point each year. This provision is not applicable to
  competitive bidding sites and is applicable to all providers, not
  just HME providers.

Regarding the manufacturer excise tax, the reconciliation bill
would replace the Senate bill provision with a different tax
provision that would also raise $20 billion over 10 years but that
would:

• Impose a 2.3 percent sales tax on medical devices sold by
  manufacturers, producers, or importers;
• Take effect in 2013; and
• Exempt certain medical devices from the tax, such as
  eyeglasses, contact lenses, hearing aids, and other devices
  determined by the HHS Secretary to be purchased by the general
  public at retail for individual use.

The reconciliation legislation now moves to the Senate for
consideration, where there will likely be a number of procedural
challenges to the bill. If the Senate makes any changes to the
reconciliation legislation, the House will have to vote on the
reconciliation legislation again.

According to AAHomecare, final passage of that legislation “may
take days, weeks, or months to complete.”

As debate continues, AAHomecare said the provisions in the
health reform bill “underscore the importance of obtaining more
cosponsors for H.R. 3790,” the bill that would repeal the
competitive bidding program, and of advocating for preservation of
the first-month purchase option.

“During the months ahead, there will likely be several occasions
in which Congress returns to health care legislation, which could
provide a vehicle for attaching language from H.R. 3790 and
language to preserve the first-month purchase option,” the
association statement said.

As of Monday, H.R. 3790 had 184 cosponsors. The industry is
pushing to move that number over the 200 mark.