Obama Opens the Door

The new political contours in Washington give the home medical equipment sector new opportunities to push for better policies and regulations. We can draw some parallels between the goals of the HME community and the Republicans’ broader goals of “repealing and replacing” the health care reform law.

For the GOP, their successful House vote to repeal the health care reform law was symbolically important. Now, Republicans move on to question, modify, repeal and replace specific parts of the health reform bill on a piecemeal basis. Likewise, the HME sector continues to push for better Medicare policies with respect to competitive bidding, power mobility, audits and other regulatory matters.

But our fight is different from the GOP repeal effort, and we have some advantages. Our efforts are far more bipartisan; we have champions in both parties. And in many ways, our fight to preserve access to home care and HME jobs is more clear-cut than the GOP’s goal of repealing and replacing the sweeping health reform law.

The chief rallying cry of the Republican repeal-and-replace effort is the charge that the health reform bill “kills jobs.” That charge is hard to prove at this point. On the other hand, the jobs and businesses that the HME sector is losing are already visible, and they are being felt in dozens of congressional districts throughout the U.S.

The cause is not simply the misguided Medicare “competitive” bidding system, although that is a significant and growing factor. Other policies that are choking off many HME providers include the increasing burden of power mobility regulations, the 36-month oxygen cap and the deluge of unreasonable and unwarranted audits. The HME provider community has suffered longer and harder than other sectors in our health care system, and unfortunately home care patients now face grave threats in terms of access to care.

Both the Obama administration and Congress have opened the door for discussion about health care regulations. The regulatory problems for HME can be folded into the larger debate over regulations and health care policy that will continue.

On Jan. 18, President Obama issued an executive order to all federal agency heads to “reduce regulatory burdens.” He cited the Regulatory Flexibility Act, which focuses on “achieving statutory goals without imposing unnecessary burdens on the public” through simplified reporting and compliance requirements and other measures to ease regulatory headaches.

HME advocates can take immediate steps to capitalize on the new environment:

• Participate in the AAHomecare Washington Legislative Conference March 16-17. Because there are about 100 new members in the U.S. House and Senate, many of these new lawmakers need to be brought up to speed on our key issues quickly. You can help as HME advocates gather for briefings and discussions before a full day of visits with congressional offices on Capitol Hill.
• Educate members of Congress about the challenges that HME providers and patients face. Send a letter to your representatives and senators introducing yourself and your company and briefly referencing HME issues that are particularly important to you. Meet with your lawmakers both in Washington and in their district offices in the state. Hold a facility tour for lawmakers and the media.
• Report problems with the bidding program and other HME policies. We are collecting information about delays in service, access problems and other problems related to the competitive bidding program. Patients, providers, clinicians and referral sources can report those by calling toll-free 888/990-0499, or by visiting www.biddingfeedback.com. The Association is also collecting information about other problems related to audits, power wheelchairs and medical supplies policies, among other topics.

Let’s take advantage of the doors that the White House and Congress have opened to air grievances and fight for HME. The president was very clear about his willingness to improve the health care law in his State of the Union Address on Jan. 25: “Let’s fix what needs fixing and move forward.”

Read more AAHomecare Update columns.

Tyler J. Wilson is president and CEO of the American Association for Homecare, headquartered in Arlington, Va. You can reach him at [email protected]. For more information on critical home care issues, visit the association’s Web site at www.aahomecare.org.