Rep. Price on HOPP Act: Patient Care + Bureaucrats Don’t Mix

WASHINGTON — Home oxygen providers got a boost last week when Reps. Tom Price, R-Ga., and Heath Shuler, D-N.C., introduced legislation to repeal the 36-month rental cap on home oxygen therapy — and it couldn’t come at a more critical time.

The Home Oxygen Patient Protection (HOPP) Act of 2009 (H.R. 2373), which would restore payments for the period of medical need, was introduced on Tuesday even as the House and the Senate, as well as President Obama, pushed ahead with discussions on how best to reform health care. The president has said he wants to be able to sign reform legislation by the end of the year.

Oxygen stakeholders have been working feverishly to get the cap repealed and to establish a platform for an overhaul of Medicare’s oxygen benefit, which they hope can be incorporated into the health care reform package.

Price, a physician, told HomeCare Monday that he champions both repeal of the cap and long-term oxygen reform.

“The 36-month cap seriously jeopardizes the quality of care that oxygen patients receive by cutting Medicare funding to oxygen providers after the initial three-year coverage period,” Price said. “Oxygen is essentially a prescription drug and should be administered by a trained professional, but [providers] have little incentive to do so, though they’re still required to, since there is no funding in place after 36 months.”

Long-term reform of Medicare’s oxygen benefit is vital, he added. “Patients need to know that they can rely on care that meets their needs,” he said. “A system that allows bureaucrats to deny patients essential care is one that needs permanent reform.”

Price has twice before introduced legislation to repeal the oxygen cap following the Deficit Reduction Act’s limit on rental payments, which took effect Jan. 1. In Congress’ last session, the HOPP Act (then known as H.R. 621), garnered 143 cosponsors. (See Price Reintroduces Bill to Repeal O2 Cap, Jan. 29, 2007.)

Shuler has championed the industry’s fight against competitive bidding, calling for an end to the program in a congressional hearing earlier this year. (See Shuler Calls on Congress to End Competitive Bidding, Feb. 12.)

The revived HOPP Act was introduced just as the Senate Finance Committee began homing in on financing options for health care reform. Those options are expected to be unveiled this week, according to Walt Gorski, vice president of government affairs for the American Association for Homecare. He noted the oxygen benefit could be one of those options.

“I think the benefit is still under serious threat for additional cuts, particularly in the Senate,” Gorski said. “We have been working to see that oxygen is not cut as part of those financing options. If it is, it will make reform far more difficult [since] the only place to cut money out of the benefit would, in essence, target the level of service that patients currently receive.”

Gorski also said the New Oxygen Coalition, formed earlier this year by AAHomecare, is continuing in its efforts to draft and introduce a long-term oxygen reform package. “That proposal will be forthcoming soon,” he said, adding that he sees the HOPP Act and oxygen reform as “hand-in-glove pieces of legislation.”

Meanwhile, if the HOPP Act can spark enough cosponsors, it could help stave off any further cuts, stakeholders said.

“My biggest concern is that we get over 220 legislators to sign on,” said Rob Brant, owner of City Medical Services in North Miami Beach, Fla., and president of the Accredited Medical Equipment Providers of America. “We need to hit that number.”

Getting a majority of lawmakers as cosponsors in the House of Representatives is needed to assure action on the bill, observers explained.

Brant is optimistic, he said, that the industry will have more leverage this time around because the effects of the oxygen cap are being felt by beneficiaries — and they are becoming more vocal about it.

“There are many patients who are speaking to their legislators about the problems they are having now that they have capped out,” Brant said. On Friday, he noted, he got a call from an oxygen patient who was having trouble finding a provider to service her oxygen needs when she comes to Florida for an extended stay. Since she was going to cap out in November, providers were telling her she needed to pay out-of-pocket.

“Patients are saying it’s not fair that they have to pay up front,” said Brant, adding that he is now advising patients to contact their legislators and urge them to sign onto the HOPP Act.

Providers are also encouraging their legislators to back the proposed legislation, according to Teresa Tatum, executive director of the Georgia Association of Medical Equipment Services. GAMES and the North Carolina Associaton of Medical Equipment Services worked with Price and Shuler in developing the new bill.

Tatum said she has received numerous phone calls, emails and faxes from providers telling her they were campaigning for support of the bill.

“Now it is time for all providers — large and small — to rally together in support of this legislation,” Tatum said. “Washington needs to hear our collective voice as thousands of us make calls and send emails requesting our members of Congress cosign this important legislation.”

The sentiment was echoed by a number of HME organizations, including AAHomecare, the National Association of Independent Medical Equipment Suppliers, members services group VGM and the newly formed Committee to Save Independent HME Suppliers (CSI:HME).

“All providers are urged to contact their House members and ask that they cosponsor H.R. 2373,” a VGM legislative alert said, noting that Democratic representatives should contact Erin Doty in Rep. Shuler’s office at 202/225-6401; and Republican representatives should contact Emily Henehan in Rep. Price’s office at 202/225-4501.

There is an urgency to getting backers’ names on the bill, Gorski said. “Health care reform is unfolding at a lightening pace. We really have never seen things moving as quickly as they are right now,” he said. “This is unprecendented.”

For his part, Price believes home care is an answer to the nation’s health care challenges. “Home care allows patients access to care in a more comfortable and more cost-effective setting. What is good for patients is good for health care,” he said.

“Home care has to be a part of reform because it provides options to patients,” Price added. “As technology expands, the ability to provide care in different settings will expand as well. The federal government is incapable of providing the responsiveness and flexibility necessary for quality patient care.”

Read the full text of Home Oxygen Patient Protection (HOPP) Act of 2009 (H.R. 2373).