Legislative Lowdown

Las Vegas

Some of Medtrade Spring’s most popular conferences covered legislative and regulatory topics, explaining the prospects for national competitive bidding, the status of “inherent reasonableness” regulations and the progress of state licensure laws. Attendees filled the chairs, lined the walls and sat on the floor at the American Association for Homecare’s legislative update conference.

Following are summaries of a few of the legislative and regulatory subjects that AAHomecare staff members discussed:

DME Competitive Bidding —

Tom Connaughton, AAHomecare’s president, said the home care industry was fortunate to escape DME competitive bidding last year, after President Bush’s 2003 budget and a successful bill in the House of Representatives touted the system as a viable way for the federal government to save money.

There are many things to distract lawmakers from health care legislation this year, but Senate Majority Leader Bill Frist, R-Tenn., and House Speaker Dennis Hastert, R-Ill., are talking about passing Medicare prescription drug/reform legislation by the end of June, Connaughton said.

The good news for home medical equipment providers is that the White House has not explicitly supported competitive bidding this year, Connaughton continued. However, Rep. Bill Thomas, R-Calif., chairman of the House Ways and Means Committee, still is a staunch supporter of the system. “It’s critical that we continue to make a lot of noise,” he concluded. “Lawmakers are saying, ‘we heard a lot [about competitive bidding] last year, but not yet this year.’”

Inherent Reasonableness —

The Centers for Medicare and Medicaid Services claims to have no “hit list” of products that will undergo “inherent reasonableness” evaluations, Cuervo said. After CMS published its interim final IR rule in December 2002, AAHomecare issued comments, and “the CMS staff is reviewing those comments,” Cuervo explained. “I would not expect any IR changes in the near future.”

However, certain items — such as motorized wheelchairs, whose use has risen 51 percent since 2001 — could be vulnerable to IR evaluations, she added.

State Licensure —

Thirteen states currently have licensure laws on the books for HME providers, according to Seth Johnson, AAHomecare’s director of public policy. These states are Alabama, Arkansas, California, Idaho, Illinois, Florida, Maryland, Mississippi, New Hampshire, New York, Nevada, North Carolina and Tennessee. Texas has a requirement for providers who sell beds in the state, but no HME licensure law. States actively pursuing licensure laws are Connecticut, District of Columbia, Indiana, Massachusetts, Ohio and South Carolina.

“AAHomecare feels that [industry-driven] state licensure laws are the appropriate way for the industry to raise the bar — to avoid situations where a state legislator who believes he was wronged by the HME industry writes a bill without industry input,” Johnson said. “Licensure will help even the playing field for all providers by requiring them to comply with the same set of rules.”

Because of the budget crises that most states now face, providers must find ways to make licensure legislation “cost-neutral,” he added. New York’s governor is trying to redact a licensure law that he says is too expensive, despite licensure fees of $800 per year.