Fate of NCB Lies in Conference, Experts Say

Washington

Pushing to resolve Medicare-reform legislation before the July 4 recess, both houses of Congress were poised to vote, at press time, on prescription drug bills that included dramatic provisions for the home care industry. In the House, the Rules Committee was working to combine two versions of a prescription drug package that included HME competitive bidding, before sending a reconciled bill to the floor for a vote. In the Senate, lawmakers were debating the final 11 proposed amendments to a prescription drug package that included a seven-year consumer-price-index freeze for durable medical equipment.

Final votes on these reform packages were slated to take place as early as June 26 in both the House and Senate. Neither the House nor the Senate version was likely to change significantly before these votes occured, and initial passage of both bills was all but assured, according to David Williams, director of government relations for Elyria, Ohio-based Invacare.

Consequently, the fate of home-care reform lies in the conference that soon will take place between representatives from the House and Senate, as the two sides try to agree on a final bill to send to the President.

“The Conference Committee could come up with a package in early- to mid-July,” Williams explained. “This whole thing is going to be done by August.”

Night and Day

When it comes to home-care reform, the House and Senate bills are as different as night and day. While both bills require the home care industry to endure cuts to help pay for a prescription drug benefit, the House version asks the industry to bear a disproportionate share of the cost burden, according to the Alexandria, Va.-based American Association for Homecare. Not only would the House version implement competitive bidding nationwide during a three-year phase-in period, but it also would reduce the home health market basket for three consecutive years and possibly add a home health copayment.

“It's worse than [the competitive bidding provision the House passed] last year, Williams said. “It allows competitive bidding to be the foundation for ‘inherent reasonableness.’ The secretary [of the Health and Human Services Department] could do competitive bidding in Dade County, Fla., and use that pricing information to [support] an IR change across the country. It's an ugly bill.”