Nothing illuminates a hard truth better than a genuine moment of candor. Just such a moment happened at last month’s AAHomecare Legislative Conference in Washington, DC, during a meeting with Lynn Dondis, legislative assistant for Sen Barbara Boxer (D-Calif). “We all like the idea of home care,” said Dondis, “but it sometimes gets caught in the weeds.”

With verbal machetes at the ready, AAHomecare members fanned out across Capitol Hill in another effort to clear those mental weeds. Similar to last year, members of the California delegation (shown below) were kind enough to let me join them. Unlike last year, however, the legislative assistants for both Boxer and Sen Dianne Feinstein (D-Calif) seemed somewhat more knowledgeable and engaged. Even the “weeds” comment seemed like an improvement.

The AAHomecare California delegation (shown here in the Hart Senate Office Building, Washington, DC) stressed the need for a time of relative reimbursement stability.

Lisa M. Getson, executive vice president of Apria Healthcare, Lake Forest, Calif, led the discussion by communicating the urgent need for legislators to leave home care cuts off the table in the event of any Medicare Modernization Act (MMA) reconciliation bill. “Home care gave at the office last year,” said Getson. “Let providers feel the full brunt of last year’s reimbursement cuts before starting again.”

Making the case for standards were Vernon R. Pertelle, MBA, RRT, CCM, director of res-piratory services for Apria, and Dale Tyer-man, vice president/general manager for Puritan Bennett, Pleasanton, Calif. “An absence of standards will lead to low quality providers who cut corners,” said Tyerman.

While the appetite for revising home care provisions of the MMA appeared to be low among the Congressional representatives we saw, there are still policies and rules that CMS can enact.

With that in mind, attendees pushed for an increase in the dispensing fee for inhalation drug therapy, elimination of the “in-the-home restriction” for coverage of mobility assistive equipment, and a provision to allow “any qualified provider” who meets the price to participate in competitive bidding (CB).

And speaking of CB, Rep Mike Ross (D-Ark) called it “the dumbest thing I ever heard of in my life.” Ross, a pharmacy and HME business owner, told conference attendees that the industry may yet have a chance to revisit CB when seniors realize that under the MMA, Medicare will pay only 30% of the first $5,100 they spend on drugs.

His frustration with competitive bidding was echoed by attendees later that day during a tense Q&A session that featured many members of the Program Advisory and Oversight Committee (PAOC) currently advising CMS. Two attendees said the PAOC was not doing enough to fight CB. In response, PAOC member Rita Hostak, Sunrise Medical, Longmont, Colo, reiterated that PAOC members were limited to a purely advisory role.

Near the end, Cara Bachenheimer, Invacare Corp, shined a light on another hard truth that change requires involvement. “The next PAOC meeting is open and it is after the proposed rule,” she said. “If 500 people showed up, that would make an impact.” In an already sweltering DC Summer, such numbers would truly turn up the heat.

Greg Thompson
gthompson@ascendmedia.com