Provider’s Effort Gives Birth to HR 5513
Working alongside Rep Joe Schwarz (R-Mich), William Deary, CEO and owner of Great Lakes Home Health and Hospice and Home Medical Equipment, helped to craft HR 5513, a bill that would bring Medicare treatment of home oxygen back to a continuous rental model.

The bill has ignited hopes of restoring oxygen rental to its previous status before the Deficit Reduction Act (DRA), and it has illustrated the importance of communication with elected officials. Indeed, after numerous discussions with providers, Schwarz proposed the bill. “I was compelled to introduce this legislation after numerous discussions with home health care providers in my district, in particular, Wil-liam Deary of Jackson, Mich,” says Schwarz.

Schwarz introduced the bill along with cosponsors Rep Tom Price (R-Ga), Rep Ralph Regula (R-Ohio), Rep Patrick Tiberi (R-Ohio), Rep David Hobson (R-Ohio), and Rep Tim Ryan (D-Ohio). “As a physician and a member of Congress, I recognize the importance of home oxygen therapy to seniors suffering from respiratory diseases,” says Schwarz. “Forcing patients to take title of oxygen equipment is a burden our seniors should not have to take responsibility for.”

With the enactment of the DRA, oxygen therapy transitioned from a continuous rental method to a rent-to-purchase model. According to an AAHomecare statement, this change effectively severs the patient-provider relationship for home oxygen therapy under Medicare, which raises numerous patient-safety issues. AAHomecare opposed that change and is now supporting HR 5513 along with other provider stakeholders. AAHomecare continues to stress the importance of providers communicating their concerns with elected officials. Schwarz also joined in emphasizing the importance of communication, saying, “The most effective means of supporting this bill would be to have individual health care providers contact their Representative in Washington and urge them to sign on to this bill.”

Congressman Schwarz vows to “stay all over” HR 5513
In the course of outlining his reasons for sponsoring HR 5513 at this year’s AAHomecare Legislative Fly-in, Rep Joe Schwarz (R-Mich) called home care a “terrific” industry and told of his family’s positive experiences with the HME world. In comments that drew a standing ovation, Schwarz expressed unwavering support for the Home Oxygen Patient Protection Act of 2006 to repeal the 36-month oxygen cap provisions of the Deficit Reduction Act. “You have my commitment to follow it. You have my commitment to stay all over it,” said Schwarz. “You have my commitment to get it through the House, and then go over and talk to our friends in the Senate and say this is another piece of good government that you folks ought to consider.”

Schwarz introduced HR 5513 along with fellow physician and Congressman Tom Price (R-Ga). Schwarz said if his bill does not pass in the current session of Congress, he will introduce it on “day one” of the next session. “I can’t believe that this bill won’t move. I would hope that it moves in this Congress,” said Schwarz. “However, the speed with which legislation moves through Congress is not tortoise like—it’s more like dead tortoise—it doesn’t move very rapidly.”

So far, the bill has eight cosponsors: Reps John McHugh (R-NY), David Hobson (R-Ohio), Ralph Regula (R-Ohio), Tim Ryan (D-Ohio), Patrick Tiberi (R-Ohio), Paul Kanjorski (D-Pa), and Rick Boucher (D-Va). New cosponsors will be posted on AAHomecare’s Web site at www.aahomecare.org.

In recognition of his leadership in Congress, American Association for Homecare Chairman Tom Ryan gave Dr Schwarz the 2006 Homecare Champion Award. In a testament to the impact one provider can have, Schwarz credited home care provider William Deary of Jackson, Mich, with bringing the oxygen issue to his attention.

Hobson-Tanner Up to 119 Cosponsors
HR 3559, the Hobson-Tanner bill, marches on with 119 cosponsors. The industry goal is to have 200 cosponsors. Introduced on July 28, 2005, by Reps David L. Hobson (R-Ohio) and John S. Tanner (D-Tenn), the Medicare Durable Medical Equipment Access Act of 2005 would remedy many competitive bidding provisions. Talking points and a sample letter to Congress in support of HR 3559 can be found at www.aahomecare.org/display-common.cfm?an= 1&subarticlenbr=227.

The recent cosponsors include the representatives pictured below.

Providers Express Concern at Competitive Bidding Forum
The announcement that more than 600 participants were listening in on the CMS competitive bidding open door forum drew a gasp from the program hosts and further illustrated the point that many stakeholders are at the mercy of competitive bidding. While the number of people interested in the session was overwhelming, the poor audibility of the call lessened its value. With a limited question and answer session, the amount of comments related to the inability to understand the call took away from time that would have otherwise been allotted to pertinent concerns.

Many comments stated that standards are too prescriptive, and CMS replied that it is working to make the standards less so. Another comment said that 60 minutes to respond to a beneficiary is unrealistic. CMS responded that it did not intend to imply that providers had to arrive at a patient’s home within 60 minutes, and said that clarification of the wording in that subject area is needed.

The rebate provision was also brought up as an area of concern, with a number of PAOC members worried about legal and administrative issues. CMS’ position is that rebates would increase the competitive nature of competitive bidding. Other concerns were that extraordinarily low bids would distort the bidding process.

More Signatures Needed to Back Sen Collins’ Letter
Sen Susan Collins (R-Me) is looking for additional signatures of fellow senators to help prevent the home health benefit from further cuts in 2007, according to an AAHomecare statement. The association’s position on the issue is that home health and other providers will continue to be at risk as long as Congress does not enact a permanent solution to the physician reimbursement problem posed by the Sustainable Growth Rate (SGR) formula. Congress currently addresses SGR annually, looking for reimbursement cuts if needed. Under such an environment, the House and Senate conferees on the Deficit Reduction Act called for the 2006 home health market basket freeze as well as the 36-month oxygen rental provision. Sen Collins’ letter to Senators Charles Grassley (R-Iowa) and Max Baucus (D-Mont) opposes any home health reimbursement freeze in 2007, but the letter still needs more signatures to have a deeper impact.

Industry mulls New PMD HCPCS Codes
New HCPCS codes for power mobility devices (PMDs) have been released by CMS, and the industry continues to gauge its impact. Information from CMS says that the new codes more accurately reflect the range of PMDs currently on the market and will allow CMS to make more reliable payments and, ultimately, more easily detect fraud and abuse. The codes were developed through discussions with industry experts and are based on recommendations of a technical expert panel (TEP), which included suppliers, manufacturers, testing facilities, rehabilitation engineers, and clinicians.

The agency says that the next step in the PMD initiative is to implement these revised codes through pricing and local coverage policies for mobility assistive equipment. This will result in a more accurate description of these technologies and support appropriate payments by Medicare. The new codes may be viewed on the SADMERC Web site at: www.palmettogba.com/SADMERC.