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.