The president’s call for a Medicare prescription drug bill on his desk by early July had the Senate and House fast-tracking their respective plans in June. And as all the plans included provisions affecting the home health care industry, it kept the American Association for Homecare (AAHomecare) and other industry advocates hopping.

“AAHomecare and our membership have been working tirelessly these last 3 weeks to strongly discourage Congress from enacting provisions that will harm those who we are entrusted to care for—vulnerable Medicare beneficiaries,” said Kay Cox, president and CEO of AAHomecare, Alexandria, Va.

The most important issue for HME providers was whether competitive bidding for DME would be part of the final package or not. The Senate version (S1), which was passed on June 27, did not include competitive bidding and instead went with a 7-year freeze on the consumer price index (CPI) increases for DME to achieve the savings needed to keep the bill’s cost under $400 billion. While not ideal, it would be more predictable and consequently less damaging to the HME industry than competitive bidding, said AAHomecare.

However, the House bill (HR1), which also passed on the 27th, did include competitive bidding—as well as many other significant differences from the Senate bill—setting the stage for a fight between the House and the Senate.

To make sure cost savings achieved through a freeze of the CPI increases—which adjust payments for inflation—would prevail over competitive bidding in the final Medicare bill Congress would send to the president, AAHomecare urged members daily to contact their congressional representatives.

A couple of factors seemed to be in the association’s favor. On June 16 the Medicare Payment Advisory Commission (MedPAC) issued a report stating that more demonstrations needed to be done to determine if competitive bidding was a workable payment method, and on June 19, President Bush issued a statement in support of the Senate plan.

However, the outlook was far from certain, said Cara Bachenheimer, of Epstein, Becker & Green, Washington, DC. “It is a question of how strongly the House and the Senate both are behind either the CPI freeze vs the competitive bidding and who is willing to give their respective provision up for something else they want in the package,” she said.

Also of interest was a provision in the Senate bill that would require HME providers to become accredited by an independent body by 2006. According to Bachenheimer, this would likely end up in the final bill. “It is very difficult to be opposed [to accreditation], both from the industry’s perspective and as well as for a member of Congress,” she said.

Education, Entertainment Highlight Heartland Conference
If the more than 75 speakers at The VGM Group’s second Heartland Conference on May 28–31 did not keep the nearly 700 attendees busy, then the opening day reception, downtown fireworks, golf tournament, pig roast, and cow chip bingo surely must have.

More than 70 manufacturers showed off their wares at the Five Sullivan Brothers Convention Center in Waterloo, Iowa.

“We couldn’t have been more pleased with this year’s event,” says Ron Bendell, president of Van G. Miller & Associates. “Our attendees told us Heartland was a valuable learning experience and that they had fun. We’d like to thank VGM Group participating manufacturers, who helped support the event, and our speakers, who commented that Heartland is becoming one of their favorite industry events.”

The conference was held in The VGM Group’s hometown of Waterloo, Iowa. The seminars covered HME/respiratory, rehabilitation, and products/technology. Most offered continuing education units from six different accrediting bodies.

The third Heartland Conference will take place June 2–5, 2004.

State News

California—Although the state legislature has, for now, rejected a 2003–2004 budget proposal that included the elimination of Medi-Cal optional services—which includes DME, medical supplies, and orthotics and prosthetics—HME dealers are not in the clear just yet.

Facing a more than $35 billion budget deficit, the Department of Health Services (DHS) still must make cuts in reimbursement that will achieve cost savings to the Medi-Cal program, says the California Association of Medical Equipment Suppliers (CAMPS).

At press time, DHS had recommended that the Medi-Cal reimbursement allowable for DME be reduced to 80% of Medicare’s allowable for all listed items. For nonlisted items, such as custom rehabilitation products, DHS is seeking the manufacturer’s suggested retail price minus 20%.

“CAMPS is making every effort it can to prevent such extreme cuts,” says Gloria Peterson, assistant executive director at CAMPS. “The rehabilitation community has been extremely active and continues efforts to educate Medi-Cal and the legislature on how devastating these cuts would be and how this could impact patient’s access to valuable services.”

Peterson urges concerned providers to keep contacting their legislators to educate them on how reimbursement reductions would affect their business. However, since legislators are more concerned about the well-being of the Medi-Cal population, according to Peterson, she recommends focusing on how cuts might impact providers’ ability to continue servicing that group of patients.

The state budget was scheduled to be signed June 15, but California budget debates often go well past the scheduled signage date. Last year’s budget was not signed until September 5, according to the California Department of Finance.

Ohio—A bill that would require HME service providers to acquire licenses passed in the full House of Representatives on May 28. Supported by the Ohio Association of Medical Equipment Services, the bill is currently under review by the Senate’s Health, Human Services & Aging committee and is waiting for a vote.

If the bill is made into law, the legislation would after 1 year “prohibit anyone who does not hold a valid license to provide [HME] services issued by the Ohio Respiratory Care Board from providing [HME] or from publicly claiming to be an [HME] services provider” unless the person is specifically exempt. In addition, the governor must appoint four Ohio Respiratory Care Board members within 3 months.

The bill states that HME services “refers to the sale, delivery, installation, maintenance, replacement, or demonstration” of HME.

Tennessee—A law effective this month strengthens the licensure requirements for providers of some types of power wheelchairs. See “Mobility Today” starting on page 18 for the full story.