I‘m not a natural salesperson. far from it. so it was with quite a few butterflies in my stomach that I followed the California delegation of home health care providers at the American Association for Homecare (AAHomecare) Legislative Conference to drop in uninvited at the office of Representative Bill Thomas (R-Calif), head of the powerful House Ways and Means Committee, and try to sell him on the idea that competitively bidding DME is not the way to save money in Medicare.

As we waited in the impressive marble hall outside Thomas’ office for the northern California members to finish their last appointment and join us, I saw a tall, fierce-looking man in a dark suit come charging out of the office trailed by four nervous-looking aides. It was Thomas and he was rushing to make it to the floor of the House for a vote. He bounded into an elevator, and when it was held up by an aide from another office, he jumped out and, with an angry look on his face, rushed off down the hall.

“How could we ever hope to get someone that busy to listen?” I wondered. “In fact, do any of the legislators have time for us, or are their aides simply placating us by listening to our information?”

I am still not 100% sure, but in the 3 years that I have been attending the AAHomecare Legislative Conferences, something does seem to be working. This year the president’s budget, for the first time in many years, did not include mention of cost savings achieved through competitive bidding for DME, and when the Senate announced its Medicare bill, it had dropped the competitive bidding provision that was included in last year’s Medicare legislation.

In 2002, Charles Grassley (R-Iowa)—a sponsor of both this year’s and last year’s Medicare legislation and chairman of the Senate Finance Committee—told AAHomecare members, “I am not your guy,” and proceeded to support a Medicare bill that included competitive bidding. This year the association issued a press release praising his work on the Medicare bill.

“I know there are countless elderly and disabled Americans throughout Iowa and across the country who are grateful for Chairman Grassley’s leadership in preserving patients’ relationships with their local home care providers,” said Kay Cox, president and CEO of AAHomecare in the release. “His willingness to make patient choice, access to quality care, and protection of small businesses a priority should serve as a model for the rest of Congress to follow.”

By the time this issue arrives at your desk, we will most likely know much more about what form the final 2003 Medicare legislation may take. In fact, if President Bush gets his wish to have the legislation on his desk by July 4, it may even be signed into law.

My hope is that these Medicare reforms will be as beneficial—or at least as harmless—to the home health care industry as possible. But should they include a provision that drastically disrupts this industry, such as competitive bidding, it will not be because this industry’s voice was not heard.

For everyone who took time away from their families and companies to come to Washington, to visit their legislators’ state offices, or to call, fax, or email their elected officials last month, you should be proud regardless of the outcome. You did your part and you made a difference, even if it sometimes can be hard to tell.

Lena Lindahl
llindahl@medpubs.com