Lobby Hard, Advocates Warn: ‘Everything Is on the Table’

ATLANTA — Congress may be in recess for the July 4th holiday, but home medical equipment providers cannot afford to take a vacation from lobbying their legislators, industry leaders warned last week.

“Congress is considering devastating payment reductions and policy changes that will have a severe and negative effect on HME providers and the patients we serve. These issues include allowing competitive bidding to move forward, significant cuts to the home oxygen benefit and the elimination of the first month purchase option for all power wheelchairs,” the American Association for Homecare reported in its Wednesday newsletter.

A House version of the health care reform bill would eliminate the PWC purchase option as a “pay-for,” and several Wall Street reports surfaced last week that, in addition, the Senate might include a 30 percent reduction to oxygen on its cut list.

“The Senate Finance Committee continues to work on their bill, and we probably won’t know all the cuts they are proposing until after the July 4 recess,” said Michael Reinemer, AAHomecare vice president, communication and policy. “That gives HME stakeholders more time to express concerns about the oxygen and power wheelchair cuts which we know are on the table.”

AAHomecare Board Member Carter Fuller, president of Fuller Rehabilitation in Ringgold, Ga., told HomeCare Monday he thought the first-month purchase option had been permanently shelved last year. But legislators “are grabbing everything they can to save money,” he said.

“I guess the moral of the story is everything is on the table. They will destroy some good things they have got going to take care of this health reform bill,” Fuller said.

“It seems like durable medical equipment is always on the hit list,” he added. “No matter that we have surety bonds and accreditation and we are trying to clean up our industry and be the model industry for health care. It doesn’t matter. They just keep on.”

Gary Gilberti of Baltimore-based Chesapeake Rehab agreed. “I’ve talked to a lot of [legislators] who believe power wheelchairs can be rented,” said Gilberti, who is also president of the National Coalition for Assistive and Rehab Technology. “We have tried to tell them this isn’t a good deal for either the provider or the beneficiary.”

But lawmakers don’t seem to get it, he continued. “Certainly people ought to contact their reps over the recess,” Gilberti said. “I think we are going to have a big battle coming up when they come back, and we need to hit them with all we’ve got.”

Fuller is so disturbed that he recently sent a letter to fellow members of the Georgia Association of Medical Equipment Services about the PWC threat.

“Unfortunately, this policy would adversely affect beneficiary access and create a catastrophic situation for [power mobility device] providers due to the immense cash flow disruption during a time when access to supplemental capital is extremely difficult to obtain,” he wrote.

Fuller noted the power mobility segment has suffered cuts of almost 37 percent in the last few years. “Do they just want to get rid of the [power mobility] benefit?” he questioned. From his perspective, that isn’t right or just for beneficiaries who depend on the benefit and who have paid into the system for years.

“We need Congress to focus on not cutting … power mobility anymore and let us be the solution to the problem,” he said.

Gilberti said he is hopeful that Congress would at least back off from eliminating the purchase option for Group 3 chairs. “We think it’s wrong for everybody — for power mobility across the board,” Gilberti said. “But it’s certainly injurious to the beneficiaries of Group 3 who need power.”

“We have to get out and meet with anybody who will listen,” said Fuller. “We need to stick together and [tell them], ‘Don’t hurt oxygen, either.’ We’re trying to help folks in the home and we need to stick together on this. We need to get with these lawmakers and educate them if we want to come out on top.”