As we all know, Congress overrode President Bush's veto of the Medicare Improvements for Patients and Providers Act of 2008 on July 15, 2008. The move sealed the victory over CMS on three key issues.

First, round one of competitive bidding was delayed for at least 18 months, and CMS must make a series of substantive improvements to the program before moving forward. Second, the law requiring home oxygen patients to assume ownership of the equipment—used to provide home oxygen therapies after 36 months of rental—was repealed. Finally, high-end/complex rehab has now been carved out of national competitive bidding programs forever.

To get any one of these issues enacted into law would have been a win, but to get all three passed at the same time means that CMS has been put on notice, by the Congress of the United States, that it has been going too far in its aggressive treatment of the HME industry—providers, manufacturers, distributers—everyone. Moreover, it has proven once and for all that Congress sees the industry as a key component of the larger battle to rein in the cost of health care in America.

After trying and being rebuffed in similar efforts so many times, what was behind this victory? How did it happen? And what needs to be done to keep the tools sharp and available when they are needed again?

One factor in the successful July campaign was that various factions in the industry came together for the first time and really worked as a coalition. The industry spoke with one voice, delivered the same messages, shared resources, and presented a united front.

Next, all the professional Washington operatives either employed by or contracted by various industry players carried the same message to Capitol Hill. A solid link was finally made with consumers and consumer groups, making all three issues compelling to Congress by a large and diverse grassroots constituency that votes. A coalition of consumer-driven organizations, including, but certainly not limited to, the American Association of People with Disabilities (AAPD), the National Council on Independent Living (NCIL), the National Multiple Sclerosis Society (NMSS), the ALS Society, and other groups, put a human face on each issue.

AAPD, NCIL, NMSS, and ALS can document more than 8,000 personal contacts—including letters, faxes, phone calls to Congress, Hill visits, and visits to local congressional offices during the weeks leading up to the final votes. These messages mirrored the industry positions.

Finally, and probably most importantly, all this was ready to unleash on Congress when they were in the waning days of a session, with a critical piece of "must pass" Medicare reform legislation. Legislation that lifted the cap on what Medicare was paying physicians had to move, because doctors were beginning to turn away beneficiaries. The three industry issues were attached to a bill reforming the physician fee schedule, and paying for it with funds earmarked for the Medicare Part C (managed care) program.

What's next? Obviously, the first order of business is going to the coalition of individuals and consumer groups who were there for us in our hour of need. Say thank you and ask what you can do in return. The industry must be prepared to offer its full-throated support for the Community Choice Act (CCA) when it is reintroduced next January. Support means putting CCA at the top of the industry's legislative agenda for the new Congress. It includes providing financial support to the consumer coalition pushing CCA, and it includes everyone associated with the HME industry becoming familiar enough with the CCA to advocate for its passage.

The next order of business is shoring up the various assets and factions within the industry coalition so that they can mobilize for future efforts. Remember, competitive bidding is not dead yet, just delayed. CMS still has a tepid congressional mandate to implement this abomination in 2009.

And finally, take a minute, just a minute, to smile, reflect on the victory, and realize the truth of the words: "We can accomplish so much more together than any one of us can accomplish by ourselves."

Cara C. Bachenheimer, JD, is VP of government relations for Invacare Corp. David T. Williams is a senior consultant on political and legislative affairs with Partners in Public Policy Inc.