Ann Howard

The President’s proposed budget for fiscal year 2008 is bad news for Medicare beneficiaries and providers, including HME companies and home health agencies. Among the provisions are a reduction of the oxygen rental period from 36 to 13 months, elimination of the first-month purchase option for power wheelchairs, and a 5-year freeze on home health care reimbursement updates.

The key Congressional committees are expected to reject many of the Administration’s Medicare proposals, as well as some of the recommendations they receive from the Medicare Payment Advisory Commission. They will craft reconciliation legislation to meet the budget targets they receive from Congress’ FY 2008 budget resolution next month.

Even though members of Congress will be expected to hold the line on spending, they once again face the physician sustainable growth rate (SGR) problem. In addition, the new Democratic majority expects to reauthorize and expand the State Children’s Health Insurance Program (SCHIP). Fixing SGR and expanding SCHIP will come with a hefty price tag.

The President’s budget may or may not be dead on arrival, but because the new Congress has pledged to restore “pay as you go” budgeting, every increase in expenditures for physicians’ and children’s coverage presumably will have to be offset by program cuts elsewhere, including Medicare provider reductions and higher premiums for wealthier beneficiaries.

Home oxygen therapy is on the table once again, as it has been for many years. Congress has reduced Medicare reimbursement for home oxygen by nearly 50% over the past 10 years.

AAHomecare, along with the National Association for Medical Direction of Respiratory Care and National Home Oxygen Patients Association, has strongly objected to forcing Medicare patients to assume the burden of owning and managing medical oxygen equipment in their homes after only 13 months of use.

Because of services required for providing oxygen therapy, it is best suited to a continuing, uninterrupted relationship with a qualified home oxygen provider. We are pleased that the Home Oxygen Patient Protection Act (HR 621) has been reintroduced in the House of Representatives by Rep Tom Price (R-Ga). AAHomecare also is working with Senate offices on reintroduction of the bill on that side of Capitol Hill. This legislation in effect rejects the 13-month rental cap and amends the DRA to restore the previous unlimited oxygen rental policy.

Ann Howard is director of federal policy for AAHomecare, Alexandria, Va. She can be reached via e-mail: .