Let the HME Lobbying Begin; ‘Groundhog Day’ on Some Issues

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 [email protected], the association said.