Editor's Note

Head to the Hill...

Capitol, that is. The Baucus bill means the industry has its work cut out for it.

• By David Kopf
• Oct 01, 2009

What is it about health reform and HME? A restructuring of the national health offers the HME/homecare industry a major legislative foot in the door to convince Congress to nix short-sighted and unworkable public policies such as competitive bidding and the36-month rental cap on oxygen.

But right when a piece of legislation pops up to give us that chance, such as the Medicare Home Oxygen Therapy Act of 2009 introduced into the House by Reps. Mike Ross (D-Ark.) and Kendrick Meek (D-Fla.), another reform package that is farworse is announced.

The latest reform to go up before congress was the enate Finance Committee Chairman’s “mark” of the America’s Healthy Future Act Chairman Sen. Max Baucus (D-Mont.), which contained a laundry list of provisions that negatively impact the HME industry. Among some of the bill’s more onerousprovisions are:

• An expansion of the number of competitive bidding areas in round two from 79 to 100 of the largest MSAs.
• A requirement that the bid program apply competitively bid rates to the remaining non-bid areas by 2016.
• An elimination of the first-month purchase option for replacing any wheelchair except for complex rehabilitative power chairs.
• Plus An annual tax would on DME manufacturers and importers of Class II or Class III devices.

What a line-up! It’s as though Baucus somehow monitored the brainwaves of providers while they slept at night, and came up with a Top 40 list of their worst nightmares. (For more details, turn to page 8 of our News, Trends & Analysis section to read deeper detail on the Baucus bill.) One thing is clear, Baucus sees homecare as a bottomless cash trough that will help fund health reform, rather thanthe threadbare change purse it actually is.

So far, President Obama has said Baucus’s proposals meet the broad guidelines he set for healthcare reform, but the President has stopped short of endorsing the bill. That’s pretty standard presidential politicking on his part, but it means health reform and more specifically the Baucus bill is still very much open for debate.

If anything, Baucus’s “mark” is the culmination of what has been a very tough year for providers. From the re-bid of round one of competitive bidding, to trying to reform the oxygen benefit and the 36-month rental cap, to protecting the firstmonth purchase option for power mobility, to obtaining accreditation and surety bonds, 2009 has been a very rocky road to travel — and we still have more than two month’s left to go.

Make sure to read this month’s cover feature on the industry’s regulatory and funding forecast for the near future and into 2010 (page 30) to see how this year has set the stage for a continuation of the tough legislative fights that providers have been waging. I wish there was a chance to catch our breath, but it looks like we’ll be going the distance.

And that’s why advocacy is so important. In addition to what our panel of experts had to say for the funding and legislative forecast, Georgie Balckburn, vice president of Government Relations and Legislative Affairs for Pennsylvania provider BLACKBURN’S, has written an Observation Deck column (page 58) that shares some insights she has gained in her advocacy work on behalf of the industry, and shows how you can help.

Also, this month’s Medtrade Fall conference and exhibition offers a number of opportunities to learn about the changing funding landscape and how you can fight for your industry. Make sure to read our show coverage starting on page 19.

Bottom line, legislation such as the Baucus proposals are a clear signal that the fight is on. If you haven’t joined the effort to protect your business and your industry, now is the time.

This article originally appeared in the October 2009 issue of HME Business.