Opponents Say Clerical Error Gives Another Shot at Defeating DRA

WASHINGTON–Inconsistencies in the language of the House and
Senate versions of the Deficit Reduction Act (S. 1932) that
President Bush signed into law Wednesday could possibly give
industry stakeholders a second chance at defeating the
legislation.

The bill Bush signed varied slightly from the final version
passed by the House, Reuters reported Thursday: Since
December, as the bill was passed back and forth between the two
chambers, a typo was written into it through a clerical error.

The House and Senate passed legislation as a fix to the error
after the president had already signed the bill, but on Friday
Democratic leaders in the House were reportedly still insisting on
a re-vote for the original measure.

According to Reuters, the error was related to Medicare
payments for medical equipment rentals. A spokesperson for the
American Association for Homecare described the error as “a typo in
[the] House version of S. 1932 that capped HME items at 36 months
instead of 13.”

As the drama of the error unfolded Thursday, industry
stakeholders found themselves in a fog of hope and uncertainty,
with erroneous and confusing press accounts circulating about the
inconsistencies.

Ultimately, though, the spokesperson added, “It’s possible that
there could be one last-ditch effort to vote again on the capped
rental provision, although it’s a long shot.”

Meanwhile, the industry is already feeling the effects of the
DRA, the provisions of which are effective Jan. 1, 2006. Late
Friday, CMS released a fact sheet outlining the changes the law
brought about, including the following:

–The DRA makes some changes to Medicare payments for rental
arrangements for durable medical equipment. Prior to the DRA,
“capped rental” items are rented by Medicare for up to 15 months;
after 15 months, the supplier continues to furnish the equipment to
the beneficiary as long as the beneficiary needs it, but the
supplier retains title to the equipment.

Beginning with items newly rented on or after Jan. 1, 2006, the
DRA changes the rental period to 13 months. After the end of the
rental period, title to the equipment transfers to the beneficiary.
Medicare will continue to pay for reasonable and necessary service
and maintenance after the end of the rental period. CMS will issue
instructions to its contractors to implement these changes later
this year.

–The DRA also makes some changes to Medicare payments for
oxygen equipment. Prior to the DRA, oxygen equipment was rented
indefinitely. The bill caps the rental period at 36 months, after
which time the beneficiary will own the equipment. After the
beneficiary owns the equipment, the DRA requires Medicare to pay
for reasonable and necessary service and maintenance. The DRA also
requires Medicare to continue to pay for gaseous and liquid oxygen
contents for beneficiaries using stationary or portable oxygen
tanks and cylinders after the beneficiary using that equipment owns
it.

The DRA provides for a new 36-month rental cap period beginning
Jan. 1, 2006, for all oxygen equipment. Thus, a new 36-month rental
cap period would apply both for beneficiaries starting to use the
equipment as well as for beneficiaries who have been using it for
several years. CMS will issue instructions to its contractors to
implement these changes later this year.

–The DRA changes from 27 to 29 the minimum number of days after
the receipt of a non-electronic (paper) claim before Medicare will
pay the claim. Medicare’s carriers and intermediaries will
implement this extended period as soon as possible.

–Caps on payments for outpatient therapy services went into
effect Jan. 1. Two separate caps are in place: $1,740 per
beneficiary per year for physical therapy and speech-language
pathology, and the same amount for occupational therapy.

The new law also requires a one-time hold on Medicare payments
for the period of Sept. 22 through Sept. 30, 2006. According to
CMS, “payment on claims that would have otherwise been paid on one
of these nine days will be made on the first business day of
October 2006.”