Key Industry Bills Await Congressional Action

WASHINGTON–A handful of home medical equipment-related bills
awaits action from Congress when legislators return from their
August recess on Sept. 4, and that action–if there is any–could
change the face of the industry.

Here’s what lawmakers will grapple with when Congress is back in
session.

–H.R. 1845 and its Senate companion, S. 1428:
The Durable Medical Equipment Access Act seeks, among other things,
to ensure beneficiary access to quality items under CMS’
competitive bidding project and to protect home care providers,
particularly small businesses.

The bills would:

• Exempt smaller, rural areas (MSAs with populations under
  500,000);
• Allow all qualified providers to participate at the selected
  award price (the House and Senate versions of the bill define
  “qualified” provider differently);
• Restore the due process rights of providers to administrative
  and judicial review; and
• Exempt items and services unless CMS can demonstrate savings of
  at least 10 percent.

The House version of this bill, known as the Tanner-Hobson bill,
also calls for Congress to reauthorize competitive bidding after
completing its rollout in the first 10 bidding areas before it can
be implemented elsewhere. In other words, Congress would
specifically have to pass a law for it to continue.

With 109 cosponsors, the bill has been referred to the House
Subcommittee on Health. Its Senate companion, known as the
Hatch-Conrad bill, has 12 cosponsors and has been referred to the
Senate Finance Committee.

–H.R. 2231: The Medicare Access to Complex
Rehabilitation and Assistive Technology Act would exempt complex
rehab and assistive technology from competitive bidding on the
basis that it is highly individualized, would not result in
significant savings for Medicare and beneficiary access would
likely be compromised. Consistent with H.R. 1845, this bill
recognizes that competitive bidding would have negative impacts on
consumers by limiting their choice of provider and limiting access
to high-quality products and services.

So far, H.R. 2231 has garnered 18 cosponsors. It has been
referred to the House Subcommittee on Health.

–H.R. 621 and its Senate companion, S. 1484:
The Home Oxygen Patient Protection Act would amend provisions in
the Deficit Reduction Act to eliminate the 36-month oxygen rental
cap and restore ownership of equipment to home oxygen providers.
The DRA, which moved Medicare home oxygen from continuous rental to
a rent-to-purchase model, requires beneficiaries to assume
ownership of equipment after 36 months of rental.

“Under the Deficit Reduction Act of 2005, Congress merely
considered the economic issues of home oxygen therapy, and not the
clinical aspects. This legislation to repeal this provision of the
DRA is in the best interest of patients, the medical community and
Medicare,” said Rep. Tom Price, R-Ga., a physician who introduced
the House bill. “Home oxygen therapy provides an essential benefit
to our seniors. Medical oxygen is complex and highly regulated, and
requiring Medicare beneficiaries to own this equipment for their
therapy raises numerous health and safety concerns.”

Cosponsors for H.R. 621 currently number 112; the bill has been
referred to the Subcommittee on Health. The Senate bill has five
cosponsors and has been referred to the Senate Finance
Committee.

–H.R. 2567 and its Senate companion, S. 870:
The Home Infusion Therapy Medicare Coverage Act would amend the
Social Security Act to extend coverage for home infusion services
to Medicare beneficiaries, a benefit currently available to most
patients in the private sector. This measure would require infusion
supplies, equipment and professional services to be covered under
Part B, with drugs covered under Part D.

When Congress passed the Medicare Modernization Act in 2003,
lawmakers added coverage for home infusion drugs. But according to
advocacy groups, CMS interpreted the law to cover only the drugs
and not the services and supplies associated with home
infusion.

The House bill has 28 cosponsors and has been referred to the
Subcommittee on Health. Its Senate companion bill has been referred
to the Senate Finance Committee.

–H.R. 1809: The Medicare Independent Living
Act of 2007 would eliminate Medicare’s “in the home” restriction
for coverage of mobility devices for individuals with expected
long-term needs.

Its authors, Reps. Jim Langevin, D-R.I., and Jim Ramstad,
R-Minn., said the bill would improve community access for
beneficiaries with mobility impairments by removing a restriction
that bases coverage of mobility devices solely on an individual’s
mobility needs inside the home.

According to Langevin, the “in the home” statutory language was
originally meant to define durable medical equipment as devices
that were provided outside of a hospital or skilled nursing
facility and, therefore, warranted separate reimbursement under
Medicare Part B rather than Part A. However, Langevin said, over
time Medicare “has chosen to interpret this language in a way that
restricts coverage of mobility devices to only those that are
reasonable and necessary in the individual’s home.”

The bill has bipartisan backing from 29 cosponsors and has been
referred to the Subcommittee on Health.

For the full text of these bills or others from the 110th
Congress, click here.