As 2004 comes to a close, could it be that CMS is entering a new era of responsiveness for the home care industry? Perhaps that is an overstatement, but the recent $57 dispensing fee for nebulizer respiratory medications is certainly a good sign. CMS Administrator Mark McClellan's participation in Dealer/Provider’s October 2004 issue even counts as a small part of this renewed responsiveness. However, as AAHomecare Chairman (and Dealer editorial advisory board member) Tim Pontius, RRT, points out in this month’s industry news, the research that CMS relied on for the $57 fee determination actually pointed to a $68 fee. Why the $11 disparity? It’s anybody's guess.

On the legislative front, all indications are that House Resolution 4491 will not see passage in 2004. However, it will not be for a lack of trying. As John Gallagher, director of government relations for Van G. Miller & Associates, pointed out at this year’s Grassroots Central at Medtrade in Orlando, Fla, the more than 100 cosponsors in Congress sent a powerful message on behalf of the industry. The bill, which would have rescinded the Federal Employees Health Benefits Program (FEHBP)-related reimbursement cuts, may be resurrected in 2005, but we will have to wait and see.

At least with the national election wrapped up, some things are certain. For example, virtually all the incumbent friends of HME/home care were reelected. People such as Sen Mike Crapo (R-Idaho), Sen Blanche Lincoln (D-Ark), Representatives David Hobson (R-Ohio), Harold Ford Jr (D-Tenn), and Mike Ross (D-Ark), all will be returning for new terms. Representative Roy Blunt (R-Mo), House Majority Whip and an HR 4491 cosponsor, also returns to office. As new legislators are cultivated one by one, new industry champions may yet arise. The good news is that home care is truly a bipartisan issue. Care in the home is more cost-effective than the same care administered in a hospital. Legislators from both sides of the aisle can take that message to their constituents with pride.

In fact, the entire industry should be proud of its honest efforts to help customers, run profitable businesses, and employ people in their local communities. In my first year as editor, I have seen and heard this dedication in the faces and voices of my readers. To get beyond the tales of fraud and abuse, lawmakers need to see these values and ultimately find the motivation to look elsewhere for cost savings. If providers can convey that sense of purpose to legislators in 2005 and beyond, perhaps a new era of responsiveness will truly begin.

With nationwide competitive bidding set to begin in 2007, industry advocates will definitely need all the responsiveness they can get. As Cara C. Bachenheimer, JD (vice president of government relations for Invacare Corp), reported in her October 26, 2004, address to Grassroots Central, CMS is aggressively going forward with plans for competitive bidding. As a member of the Program Advisory and Oversite Committee (PAOC) giving input to CMS on behalf of the industry, Bachenheimer’s words should be enough to sound the alarm. The next PAOC meeting is December 6 and 7, so stay tuned.

CMS seems to regard competitive bidding as a done deal, so changing that mind-set will not come easily. Then again, few things worth fighting for do come easily. For example, few expected Maximum Comfort Inc’s legal victory in 2004, but president and founder Tom Lambert (last month’s cover subject) chose to fight. Other well-chosen battles may yield equally positive results. You just never know.

Whatever happens, we will be there to help you thrive with practical articles that inform and inspire. As the industry enters 2005 with optimism and resolve, I give you all my heartfelt thanks and best wishes for a happy new year. Be well.

Greg Thompson
gthompson@medpubs.com