By the time you read this, the 110th Congress will have less than 45 days before the end of the year. They will work from now until they take a break (called a district work period) for Thanksgiving. Then they may, or may not, return to Washington for a week or two to deal with unfinished appropriations legislation, and other unfinished business.

During that time, Congress will spend a lot of time and energy talking about the war in Iraq, and working on the 13 different appropriations bills that must be passed to keep the government functioning. Here's a prediction: look for Congress to pass one or two "continuing resolutions" to keep the government running, and then rolling most of the appropriations bills into an "Omnibus" piece of legislation that is passed just before Congress adjourns for the holidays.

Beleaguered HME and rehab providers are probably wondering: What is going to happen to the four pieces of legislation the industry is pushing? With competitive bidding scheduled to go live in 10 cities next July, passage of these bills seems imperative. However, there are so few legislative days left in 2007, and so many issues of major significance demanding the attention of members, that industry advocates are wondering how and if the legislation important to them can be passed.

HR 1809, the Medicare Independent Living Act of 2007, was introduced by Representative Jim Langevin (D-RI), and has 31 bipartisan cosponsors—many of whom signed on after the bill picked up the support of consumer organizations. If passed, this bill would eliminate CMS' restrictive "in the home" coverage requirement for power mobility devices. But cosponsors do not translate into action, and HR 1809 has had no hearings in committee, and none is yet scheduled. It is highly unlikely that this legislation will become law in 2007.

HR 2231, the Medicare Access to Complex Rehabilitation and Assistive Technology Act of 2007, defines complex rehab technology and medical necessity for this product category, and would exclude it from competitive bidding. The so-called "rehab carve-out bill" was introduced by Representative Tom Allen (D-Me), and has 18 cosponsors. It will likely suffer the same fate as HR 1809.

HR 1845, the Medicare DME Access Act, has 112 bipartisan cosponsors. It is better known among industry advocates as "Tanner/ Hobson" because the original cosponsors are Representatives John Tanner (D-Tenn) and Dave Hobson (R-Ohio). This bill would make several significant changes to the competitive bidding program. Most notable among them are the "any willing provider" provision and the moratorium on the program after the initial 10 sites—unless Congress specifically reauthorized the program. Companion legislation—S 1428—was introduced in the Senate by Senators Kent Conrad (D-ND) and Orrin Hatch (R-Utah), who are both members of the powerful Senate Finance Committee.

HR 621, the Home Oxygen Patient Protection Act, was introduced by Representative Tom Price (R-Ga), and has 115 bipartisan cosponsors. HOPPA would rescind the provision contained in the Deficit Reduction Act requiring beneficiaries to assume ownership of home oxygen equipment after 36 months, and would repeal the 36-month payment cap. Like Tanner/Hobson, HOPPA has a Senate companion bill (S 1484) introduced by Senator Pat Roberts (R-Kan). The Senate version of HOPPA has seven cosponsors, including Senator Ken Salazar (D-Colo), the newest member of the Senate Finance Committee.

There is still a glimmer of hope for Tanner/Hobson and HOPPA, and that is their connection to the Senate Finance Committee. This is the Committee that will write "must-pass" legislation to fix an error relative to physician fee schedules contained in the Deficit Reduction Act. Depending on how seriously the Committee takes what are expected to be outrageously high CBO cost estimates, either or both of these bills could be attached to this virtually veto-proof legislation. The same can be said about HR 1809 and HR 2231, if they can find a champion on the conference committee, or among the House leadership to insist that they be included.

So the mantra for the industry remains "energize and engage the grassroots." That means providers and their employees must contact their legislators to sign on as cosponsors for all four pieces of legislation. More importantly, no stone should be left unturned in the effort to get consumers/beneficiaries to write their representatives and urge their support of these bills. Leadership sees the number of cosponsors as an indicator of grassroots interest in the issue. Going into a hotly contested election year, Congressional leaders in both political parties want to keep the grassroots happy.

Cara C. Bachenheimer, JD, is VP of government relations for Invacare Corp. David T. Williams is a political and legislative strategy consultant.