Despite Recess, Medicare-Reform Legislation Inches Along

Washington

When the members of the Medicare Prescription Drug Conference Committee headed home for the August recess, they left behind representatives who were able to agree on a key provision of the compromise: a Medicare prescription drug discount card.

“Conferees, through their staff, have worked through scores of issues, and while some technical drafting still needs to be completed, only one issue remains in [the discount card] area,” the House of Representatives Ways and Means Committee reported Aug. 5.

This agreement clears the table for negotiations on “non-controversial provider issues,” set to begin this month according to a schedule that Ways and Means Chairman Bill Thomas, R-Calif., drafted before the recess. Whether Thomas considers home-care provisions, such as national competitive bidding for durable medical equipment, to be “non-controversial provider issues” is not clear.

The Committee also agreed on a set of Medicare regulatory and contracting reform provisions that included standards for claims reviews and increased funding for provider education. For an in-depth look at these provisions, see this month’s “Washington Wit & Wisdom” column on page 88.

For durable medical equipment providers, the steady progress toward Medicare reform means lawmakers soon could decide the fate of several home care-related provisions, including one in the House version that calls for national competitive bidding. An alternative provision, which is part of the Senate’s reform package, would freeze consumer price index reimbursements for DME for seven years.

However, the Congressional Budget Office has said both Medicare bills would exceed the $400 billion lawmakers set aside earlier this year to pay for a prescription drug benefit, according to a July 22 report from the U.S. Congressional Budget Office.

Depending on how one slices the pie, the House bill could exceed the limit by anywhere from $8 billion to $167 billion during the next decade. The Senate bill could exceed the limit by anywhere from $22 billion to $62 billion during the same time period.

What this means for the home care industry is that House and Senate conferees currently negotiating a compromise on Medicare reform will be looking for ways to save. “As co-chairs of the House delegation, we pledge to keep the cost of the Medicare conference report under the $400 billion figure agreed upon in the Budget Resolution,” House Ways and Means Chairman Bill Thomas, R-Calif., and House Energy and Commerce Chairman Billy Tauzin, R-La., promised in a joint statement.

Thomas, who is serving as chairman of the Medicare-reform conference committee, is a self-avowed champion of competitive bidding for durable medical equipment, a program he believes could save Medicare billions during the coming decade.

For breaking news, go to www.homecaremonday.com, the electronic news service of the home medical equipment industry.