‘Doc Fix’ Is Back, and So Are Possible Cuts

WASHINGTON–The so-called “doc fix” is back. And,
once again, that could mean trouble for HME.

Unless Congress acts, a 10.6 percent pay cut for Medicare
physicians will take effect July 1, with additional cuts to follow
in 2009 and after. The reduction had originally been scheduled for
Jan. 1 of this year but, shortly before Christmas, Congress passed
a law that put it off until July.

The six-month patch gave this industry a short reprieve. But now
that federal legislators are again hunting for ways to fund the
“doc fix,” HME could be back on the chopping block in the form of a
shortened oxygen rental cap and elimination of the first-month
purchase option for power wheelchairs.

Last week, Montana Democrat Max Baucus, chairman of the powerful
Senate Finance Committee that oversees Medicare, told reporters he
wants to block the docs’ pay cuts for 18 months and, in
addition, give them a 1.1 percent raise. He also wants the
legislation Congress crafts to expand beneficiary access to
preventive care benefits and primary care, and to offer more
financial help for low-income seniors.

While the scale of the Medicare package remains in question,
reimbursement for other providers could be reduced to help pay for
it no matter what it includes.

“I continue to hear from staff that no specifics have been
determined yet as to provisions to be included in the package, and
that everything remains on the table for potential inclusion as the
negotiations continue over the next week or so, including
elimination of the power wheelchair purchase option and further
reductions to oxygen,” said Seth Johnson, vice president of
government relations for Pride Mobility Products, Exeter, Pa. He
added that many on Capitol Hill agree the final package may contain
only the 18-month fix for physicians “and very little
else.”

Baucus noted that managed care funding cuts could help in
financing the legislation. However, he continued, “There are
lots of ways to skin a cat. There are all kinds of ways to find
solutions around here. That’s our job, to find compromises
and accommodations.”

Johnson said the Medicare package could be considered by the full
Senate as early as mid-May.