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Legislation & Regulation

Coverage of federal and state legislation and regulation affecting HME providers, home health agencies and patients.

  • A Rose Among Thorns

    During the five years since the Balanced Budget Act of 1997 took effect, the risk profile for home medical equipment and respiratory companies — a critical factor in merger and acquisition strategy and valuation — has remained constant. Market dynamics have been stable, and reimbursement threats from competitive bidding, inherent reasonableness and average wholesale pricing for nebulizer medications never gained enough traction to become more than a steady, annoying drone. However, the threats increased in 2002. If not for the lack of a Medicare-reform package to attach it to in the Senate, some form of national competitive bidding legislation very well could have become law last year. Still, even if the industry manages to hold the line on NCB, the Centers for Medicare and Medicaid…
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  • Bush Proposes Medicaid Overhaul

    Washington One day after the U.S. General Accounting Office added Medicaid to its 2003 list of “high-risk” programs, the Health and Human Services Department Jan. 31 unveiled a plan for sweeping Medicaid reform. As many state governments are facing the worst budget shortfalls since World War II, the Bush administration is proposing a cash infusion for states that choose a new, more-flexible Medicaid option. Instead of matching state Medicaid expenditures, this option would provide for two annual federal allotments: one for acute-care health insurance and one for long-term care and community services. It also would give state officials the flexibility to adjust and/or cut benefits to “non-mandatory” Medicaid populations, such as elderly Americans receiving institutional care. In exchange for choosing this flexible option, states would…
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  • Latest Legislation & Regulation News

  • Bush’s Budget to Fund Shift to Home Care

    Washington As the nation waited anxiously to hear the President’s Jan. 28 State of the Union Address, administration officials provided a sneak preview of Bush’s 2004 budget proposals. Health care highlights included a $1.75 billion program to help disabled elderly people make the transition home from an institution, a plan to restructure Medicare, and a boost in funding to address chronic diseases such as asthma and obesity. Early in 2001, Bush announced a New Freedom Initiative, designed to help disabled Americans integrate more fully into society. To further this initiative, the 2004 budget will include a five-year, $1.75 billion program that will encourage states to revamp long-term care systems to provide more cost-effective choices between institutional and community-based care options. “The President and I are…
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  • Senate Omnibus Bill Does Not Mention HME

    Washington Home medical equipment providers breathed a sigh of relief Jan. 24, after the U.S. Senate passed a $390 billion omnibus budget package that did not include HME competitive bidding. The omnibus package consists of 11 appropriations bills that address almost every government function for the 2003 fiscal year. Responding to Senate Finance Committee Chairman Chuck Grassley’s request, the package delayed a 4.4 percent Medicare physician reimbursement cut, slated to take effect this year, and brought reimbursements for rural and small urban hospitals in line with reimbursements for large urban hospitals. The Senate’s package also included a 5 percent rural home health add-on for a six-month period, ending Sept. 30, 2003. “The current 10 percent rural add-on is scheduled to expire April 1, 2003, if…
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  • National NewsWire

    Noteworthy CMS to Conduct Smoking-Cessation Pilot: The Baltimore-based Centers for Medicare and Medicaid Services will conduct a pilot program in seven states — Alabama, Florida, Missouri, Nebraska, Ohio, Oklahoma and Wyoming — to test smoking cessation-strategies for older smokers. Although Medicare normally does not cover smoking-cessation therapy, it will cover the therapy for those enrolled in the study. Only people 65 and older who are enrolled in fee-for-service Medicare Part B are eligible to participate. For more information, call (866) 652-3446. JCAHO Panel Requests Comments on Asthma-Care Standards: The Disease-Specific Care Asthma Expert Panel, fielded by the Joint Commission on Accreditation of Health Care Organizations, is requesting review and public comment on its initial set of candidate-standardized measures that address key aspects of asthma care….
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  • Grassley Urges Probe of OIG Vacancies

    Washington Sen. Chuck Grassley, R-Iowa, is concerned that turnover among top officials at the Office of Inspector General could compromise the office’s ability to police health care fraud, according to a spokeswoman for the senator. After receiving “numerous allegations from several whistleblowers,” about significant personnel changes at the OIG since Inspector General Janet Rehnquist took office in Aug. 2001, Grassley asked the U.S. General Accounting Office to review the situation. According to the whistleblowers, Rehnquist has mandated involuntary retirements and reassignments for 19 senior-level staff members, including six long-time deputy inspectors, during her tenure at OIG. “I can’t overlook the loss of high-ranking government servants with decades of service who have performed their jobs well,” Grassley said Oct. 22. “My judgement of their performance is…
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