Rep Dave Hobson (R-Ohio) kept his word and, along with Rep Harold Ford (D-Tenn), introduced a bill on June 24 that would repeal the cuts scheduled for January 2005 for certain DME items based on Office of Inspector General (OIG)-gathered data from some Federal Employee Health Benefits Programs (FEHBPs).

Hobson and Ford took a bold step, but the chances of this bill becoming reality depends, in large measure, on whether every provider in the HME industry contacts his or her member of Congress and demands that they sign on as a cosponsor of this important legislation.

The bill, HR 4491, would repeal the provision in last year’s Medicare bill, Section 302(c)(2) of the 2003 Medicare Prescription Drug, Modernization, and Improvement Act, now known as the Medicare Modernization Act or MMA. This provision requires CMS to cut Medicare reimbursement rates to be in line with rates that the OIG identified in 2002 from certain FEHBPs. The DME items slated for reimbursement cuts are oxygen, hospital beds, standard manual and standard power wheelchairs (K0001 and K0011), nebulizers, air mattresses, and diabetic supplies (lancets and strips).

This is an election year, and neither the White House nor the Republican leadership in Congress have much interest in doing anything to modify provisions of the MMA. But, if enough members from both parties sign on as cosponsors, the legislation could be folded into another bill or dealt with in the appropriations process. The goal for the industry is to get at least 65 Republicans and 65 Democrats in the House to become cosponsors. Unless a significant number of cosponsors are recruited, the industry will not be able to advance its effort to derail these planned cuts.

Here’s how you make that happen. Write a letter to your member(s) of Congress and specifically ask them to cosponsor HR 4491. The industry’s political strategy is multifold. The bill could get attached to a moving legislative vehicle later this year—but only if we first have significant numbers of Congressional members signing on as cosponsors.

In addition, broad Congressional support for the bill will provide leverage with CMS if it moves to implement the cuts for January 2005. Again, the industry must first generate significant support to repeal this provision. As Congressman Hobson told the 25-person Ohio delegation of HME providers at the AAHomecare Legislative conference in June, “…if the industry can get 130 members of Congress to support this bill, the leadership in Congress will have to take notice.”

Each and every provider in the HME industry must write their members of Congress urging them to sign on as cosponsors to HR 4491. Use the points below in your letter. Importantly, at the end of the letter you must specifically ask your Rep to sign on as a cosponsor of HR 4491.

Use the following points as a guide in your letters:
1) Background: The MMA contains a provision to make reimbursement cuts to five categories of DME, based on FEHBP (Section 302(c)(2)). These payment cuts should be repealed for the following reasons.

• The data used to identify FEHBP pricing was scanty at best, even by the OIG’s admission. In a June 2002 letter to Sen Tom Harkin (D-Iowa), the OIG stated that the data used to identify FEHBP pricing was insufficient for an “inherent reasonableness” reduction. Bad data makes bad policy.

• This provision was inserted in the Medicare bill at the eleventh hour, providing members of Congress with no opportunity for consideration or debate about the merits or deficiencies of the proposal.

• Suppliers’ costs of doing business with the FEHBP plans are significantly less than their costs in dealing with the Medicare program, and that difference would not be reflected in a simple comparison of payment levels.
Close the sale by politely but firmly asking your representatives to become a cosponsor of HR 4491. Two weeks after sending/faxing your letters, make sure you follow up by calling your representative’s office to determine whether the member will become a cosponsor of HR 4491. Ask if he or she needs additional information, but most importantly, close the sale and ask for their commitment to become a cosponsor. If you cannot obtain a commitment, ask them why they cannot support you. To look up your Representative’s contact info, go to: http://thomas.loc.gov:8081/home/legbranch/legbranch.html.

Cara C. Bachenheimer, JD, is vice president of government relations for Invacare Corp, Elyria, Ohio. David T. Williams is a consultant for political and legislative strategy.