Industry Awaits Bush Budget, Prepares for Action

WASHINGTON–With President Bush’s 2008 budget proposal expected
today, industry stakeholders, alarmed by rumors that it will
include provisions harmful to home care, have been gearing up for a
response.

In a recent interview with Treasury Secretary Henry Paulson, the
Wall Street Journal reported that the president’s new
budget contains proposals that could generate $90 billion in
Medicare savings, mainly from health care providers with some
beneficiaries also affected (see HomeCare Monday, Jan. 29).

But as of Friday, Washington insiders said they had received
verbal confirmation of two proposals more specific to HME: one for
a 13-month cap on home oxygen therapy, and another to eliminate the
first-month purchase option for power wheelchairs. The two
proposals would be a repeat performance on the president’s part,
having also been recommended in his 2007 budget (see “Bush Budget Proposes 13-Month O2 Cap,” Feb. 13,
2006). Both proposals were defeated after intense lobbying
efforts by the industry.

Although implementing any specific budget recommendation the
president makes would literally require an act of Congress, HME
advocates say the prospect of further cutbacks is threatening.

“A 13-month [oxygen] cap would have a tremendously negative
impact, not only on the industry but on patients as well,” said
Walt Gorski, the American Association for Homecare’s vice president
of government affairs. “Clearly, we will need to harness the
collective efforts of the entire field to fight this proposal if it
comes to pass–doing even more than we did last year.”

The association “must also work to actively engage our patients
to understand the real impact of such a proposal and help tell
Congress why it should not be enacted,” Gorski said.

Mike Marnhout, president and CEO of Lexington, Ky.-based
Bluegrass Oxygen, said that while the current 36-month oxygen
rental cap is bad enough, a 13-month cap would be “devastating,”
causing many providers to be forced out of business and
beneficiaries to suffer due to a lack of service.

“For us to save our businesses, [large and small providers are]
going to have to join hands, and it’s going to have to be a
collaborative effort to stop this,” Marnhout said.

Last month, Rep. Tom Price, R-Ga., reintroduced the Home Oxygen
Patient Protection Act, which would repeal the 36-month cap enacted
under the Deficit Reduction Act, but the bill must gain enough
support in the House and a companion bill in the Senate to
pass.

Regarding elimination of the first-month purchase option for
power chairs, Seth Johnson, chair of AAHomecare’s Rehab and
Assistive Technology Council and director of government affairs for
Pride Mobility, said it “does not make sense” for Medicare to rent
this equipment. He said a Pride position paper shows that
eliminating the purchase option would cost Medicare more money than
it would save.

“A very significant majority of the beneficiaries who need a
power wheelchair need it because they have a long-term debilitating
condition,” Johnson said. “They’re going to need that device for
the rest of their lives.”