“The only way to defeat Thomas (and thus competitive bidding) is to gather sound actuarial data from independent sources that prove beyond all reasonable doubt that competitive bidding, as proposed, is nothing more than government-sponsored price setting, and will eventually result in costs for HME spiraling out of control.”

While Congress is in recess and the President-elect awaits inauguration, the industry must prepare and prioritize its agenda for the next 2 years. Congress will be sworn in on January 4 and adjourn until after the inauguration on January 20. In the intervening time, members will be shuffling offices and new members will be recruiting staff. In addition, most of the members will be spending time in their home districts trying to develop their personal agendas for the next 2 years. Industry advocates must take advantage of the 16 days to reacquaint themselves with their elected representatives in both the United States House of Representatives and the United States Senate.

This is a time when agendas are developed. It is critical that the industry work hard to ensure that as many of these new agendas as possible have appropriate positions on the issues important to the continued vibrancy and growth of the home health care/HME services industry.

One of the first issues should be repealing the Federal Employees Health Benefits Program (FEHBP)-based pricing initiative contained in the Medicare Modernization Act (MMA). This is a poorly thought out initiative, developed at the 11th hour, and passed under the cover of darkness. The industry cannot afford to rest until this provision is repealed. This is and must be the industry’s top priority.

The next issue should be to continue to make a great case against nationwide competitive bidding. At least for the next 2 years, there is no reason to believe that House Ways and Means Committee Chairman Bill Thomas (R-Calif) will not still be the “800-pound gorilla” on all health care issues. He is determined to institute competitive bidding. The only way to defeat Thomas (and thus competitive bidding) is to gather sound actuarial data from independent sources that prove beyond all reasonable doubt that competitive bidding, as proposed, is nothing more than government-sponsored price setting, and will eventually result in costs for HME spiraling out of control.

The third issue must be to work with the staff at CMS to make certain that they implement mandatory accreditation in a way that is both fair and raises the bar in such a way as to make it extremely difficult for unscrupulous providers to get into the HME services industry. This is an important opportunity, and the industry must be seen as a force driving implementation of this initiative. Aside from creating some sort of “self policing” mechanism, it is the single most significant way the industry can improve its credibility among both bureaucrats and elected representatives.

There are a number of other issues contained in the MMA that the industry must monitor and be prepared to react to as they arise. At the same time, members will be coming back to Washington having heard an earful of complaints about the gross inadequacy of the prescription drug plan contained in the MMA. For this reason, it is entirely possible that there will be an early introduction of legislation to “correct” the MMA and this will provide many opportunities.

The HME services industry is truly at a crossroads. The industry can establish its credibility by how it responds and interacts with both the staff of a new Congress and the staff at CMS. Position papers criticizing past acts of Congress will do nothing to help the industry. Advocates must approach each opportunity with fresh ideas and constructive suggestions.

Fresh starts require fresh ideas that clearly demonstrate that the industry is ready, willing, and able to work with Congress and CMS in ways that are fair, equitable, and designed to ensure patient access to quality goods and services at reasonable prices.

Equally important is the fact that the industry must acknowledge that a small percentage of providers have taken advantage of existing policies and submitted fraudulent claims that have cost the Medicare Trust Fund millions of dollars. The industry must be clear that it is willing to work with the government to reduce and eliminate fraud.

The changing of the guard can be a traumatic experience. It can also provide unprecedented opportunities for building cooperative relationships that can result in positive outcomes on issues important to the HME services industry.

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.