John and Mark's HME Issues Scorecard

With most every sector of the home medical equipment industry undergoing major change, or soon to be, it's hard to keep up with all the curveballs. Providers are wrangling with ongoing effects of the oxygen cap, PAP clarification policies, documentation issues for power mobility and a growing barrage of audits while trying to gauge the impact of health reform — and, of course, still fighting the fast-approaching implementation of Round 1 competitive bidding.

To help keep track of some of the most recent developments as well as a few you might have missed, VGM Group's John Gallagher, vice president of government relations, and Mark Higley, vice president of development, put together the following "scorecard" of current legislative and regulatory issues — and how these issues are shaping the HME industry. Their straight-down-the-middle discussion should give you a perspective on where your business stands today, and hopefully help you hit a homer for its future.

John's Legislative Updates

• Competitive Bidding

  On April 22, H.R. 3790 reached the magic number. Including Rep. Kendrick Meek, D-Fla., the original sponsor, the bill to repeal competitive bidding hit 216 supporters and has continued to climb since, heightening the chance for the language of this bill to move forward. While it will benefit to continue gaining more support on the House side, our focus should now be directed to the Senate side to push for a companion bill.

  Additionally, at press time House Ways and Means Committee Chairman Sander Levin, D-Mich., had requested that the Congressional Budget Office score the bill to ensure that it is budget-neutral.

  But with elimination of the program, legislators will ask what will replace competitive bidding to save the government money. One of the things that the DME industry may push for at this point would be further consideration of reimbursement as a fee for services — versus fees for delivery of products.

• 36-Month Oxygen Cap

  Oxygen providers and their patients continue to face issues with the payment cap on oxygen. Traveling patients have an especially difficult time finding a provider to supply their oxygen needs. The primary threat to the home oxygen benefit is the continued belief by policymakers that the oxygen benefit is simply an equipment-based benefit that requires little if any service to meet patient and physician expectations.