Do you remember the old cliché, As GM goes, so goes the country? In many ways, the same can be said of Invacare's relationship to the HME industry. "I really worry about competitive bidding," said Chairman Mal Mixon at a recent all-day media event, "because we're the largest creditor in the industry."

Invacare is one of many companies that stand to lose a lot if certain worst-case scenarios come to pass. When the House of Representatives recently passed State Children's Health Insurance Program (SCHIP) legislation that included an 18-month cap on oxygen rental, the move pleased no one, least of all the Ohio-based giant. "The 18-month cap scares the heck out of me," commented Mixon. "If these providers go bankrupt, I go bankrupt."

The 18-month cap and the first-month power wheelchair purchase option are two of the issues that a Congressional conference committee may have already decided on by the time you read this—but not likely. Experts tell me that both sides of Congress are far apart on any SCHIP legislation and President Bush does not like either version. SCHIP renewal is due on September 30, so something will have to be agreed on. The likely result may be a continuing spending resolution that continues SCHIP and avoids many of the contentious HME issues.

Yet another important day is the September 25, 2007, deadline to submit bids for the first round of competitive bidding. In my last message, I boldly proclaimed the first round over—only to be proven wrong when the 60-day extension came down. Could another extension be forthcoming? Not likely, but you never know.

If you are reading this message at Medtrade, you know if the first round is really over, but the fate of the industry's major legislative initiatives—such as HR 621/S 1484, the Home Oxygen Patient Protection Act, which has 112 cosponsors in the House and five cosponsors for the Senate version—is still up in the air.

Here's a quick review of the other major initiatives:

• HR 1845/S 1428 would include the "any willing provider" provision to allow all providers who qualify to bill Medicare at the winning bid price. At press time, the bill has 109 cosponsors in the House. The Senate version has 12 cosponsors.
• HR 2231 would define and carve out/exempt "complex rehabilitation and assistive technology" from competitive bidding. It has 18 cosponsors at press time.
• HR 1809 (currently with 18 cosponsors) would eliminate the "in the home" wheelchair reference from the Social Security Act.

We know that demand will relentlessly drive the need for more HME. While experts say the pieces of legislation mentioned above have little chance of passing on their own, they could be added to "doc fix" legislation or an appropriations bill. With each cosponsor, the odds go up.

Greg Thompson

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