A Time for Advocacy: What Are You Doing to Protect Your Clients?

• By Elisha Bury
• Jul 01, 2007

Today, it seems that home respiratory care is being hit from all sides. Reimbursement cuts have threatened to limit access for respiratory patients, and several organizations — as well as legislators — have already taken a stand. Many patients may be unaware of these threats to access. That means providers and therapists must get patients involved and step up advocacy efforts. This summer, whether you march to Washington or participate in a community outreach program, here are some opportunities for greater involvement.

Legislation Push
Providers in the initial 10 MSAs have just wrapped up bids for competitive bidding, and many in the industry are groaning about the repercussions on profit margins and whether or not they have enough time in the day to service equipment. Competitive bidding impacts more than bottom lines, however — it could greatly impair access and further complicate the process for people already coping with chronic illnesses.

Fortunately, providers can speak out to legislators who have the power to stop it. Already, industry leaders have proposed two bills — Tanner-Hobson in the House and the companion bill S. 1428 in the Senate — to amend competitive bidding.

On March 29, Congressmen John Tanner (D-Tenn.) and David Hobson (R-Ohio) introduced H.R.1845, the Medicare Durable Medical Equipment Access Act of 2007. The bill would amend competitive bidding to protect patient access to quality care.

AAHomecare has urged providers to ask their senators to co-sponsor S. 1428, introduced in May by Sens. Orin Hatch (R-Utah) and Kent Conrad (D-N.D.). Like the Tanner-Hobson bill, the Senate bill would address some of the problems with competitive bidding, including exempting smaller, rural areas (metropolitan statistical areas with populations less than 500,000); allowing small providers that do not receive a contract to continue to provide home medical equipment at the competitive bid rate; restoring the rights of participating providers to administrative and judicial review; and exempting items and services unless savings of at least 10 percent can be demonstrated.

Work is also being done on the home oxygen front. On May 24, Sens. Pat Roberts (R-Kan.) and Jack Reed (D-R.I.) introduced the Home Oxygen Bill, meant to restore Medicare policy for oxygen therapy that was in effect before the Deficit Reduction Act — that is, before the 36-month cap. The bill is a companion to the Home Oxygen Patient Protection Act (HOPP), H.R. 621, which had 83 co-sponsors at press time.

The Home Oxygen Patient Protection (HOPP) Act was introduced in January by Congressman Tom Price (R-Ga.). A provision in the DRA forces home oxygen patients to assume ownership of and responsibility for medical oxygen systems after 36 months of rental in Medicare. That law raises numerous patient-safety issues. The HOPP Act would restore ownership of oxygen equipment to the provider.

The Council for Quality Respiratory Care (CQRC), a coalition of home oxygen therapy providers and manufacturers, has been vocal about the recent legislative efforts. The CQRC Web site, www.cqrc.us, houses information on how providers can get involved.

Asthma Outreach
Did you know that approximately 20 million people living in the United States are diagnosed with asthma, and that approximately 5,000 people die from complications each year. The cause in many cases is simply a lack of understanding about treatment and not having access to resources that can help.

Fortunately, providers can play a vital role in the education of patients, and many organizations are helping providers do just that.

What’s My IgE?
www.whatsmyige.com
The Asthma and Allergy Foundation of America (AAFA) recently launched the “What’s My IgE?” campaign as part of May’s National Asthma Awareness Month. The initiative was designed to educate the public about allergic asthma, raise awareness of IgE testing as a means of screening and motivate patients to speak with a specialist for improved asthma management. According to Mike Tringale, director of external affairs at AAFA, IgE testing may provide patients with the information they need to decide the most appropriate treatment with their asthma specialist. As part of the “What’s My IgE?” campaign, AAFA offered free IgE screenings to asthma patients in select cities. IgE screenings involve a simple blood test, similar to those for cholesterol or diabetes that can be conducted in as little as two minutes. Visit the Web site for downloadable brochures and tools to assist patients.

Pediatric Asthma Initiative
www.pediatricasthma.org
The Robert Wood Johnson Foundation recently launched a Web site detailing the work of 14 asthma research teams across the country. The site features successful interventions and discusses how individual communities, emergency departments and health care systems have put theory into practice. The projects supported by the foundation used clinical and non-clinical approaches to improve the management of pediatric asthma among members of high-risk populations. They included three national programs.

Oxygen Network
Clinicians, suppliers, manufacturers, payors and patients now can connect in one place, the LTOTNetwork Web site, www.ltotnet.org. The organization is working to improve access to oxygen, efficiency of use, compliance and reimbursement.

Though the site houses many resources for providers, it also includes a patient area that answers common questions about oxygen therapy and provides a forum for patients to share their thoughts on current equipment. Providers also can take advantage of a Resources page with links to many oxygen organizations.

A great resource for patients to learn about their disease is portableoxygen.org, a site that compiles information from various sources. The site, which the American Thoracic Society (ATS) has honored as “best Web site in the Pulmonary Rehabilitation category,” offers a comprehensive guide to COPD, including equipment choices and a Q&A forum from the user’s perspective.

Sleep Community
The medical community and nation are continuing to learn more about the impact of sleep apnea on health. As the consequences of untreated sleep apnea gain more attention, the opportunities for advocacy also grow. Sometimes the best way providers can advocate for patients is by helping them speak up to Congress.

Fortunately, the American Sleep Apnea Association has a forum to guide patients through the process. The Apnea Advocacy Action Program, located at www.sleepapnea.org/advocacy, provides the tools necessary for sleep apnea patients and their families to write to members of Congress.

The first Call to Action on the site is for additional funding for the Centers of Disease Control and Prevention (CDC) to add questions about sleep and sleep disorders to its national health surveys. The information would allow the CDC to better grasp the magnitude of the problem, increase awareness and hopefully initiate efforts to help solve it.

Visitors to the site can find elected officials by zip code, track elections and candidates, and join the Action Network to receive important updates on key issues.

This article originally appeared in the Respiratory Management July/Aug 2007 issue of HME Business.