No Time Like the Present

It's July, and Congress is knee-deep in its consideration of Medicare reform provisions and development of a Medicare prescription drug benefit. With 2004 elections just around the corner — at least in Washington terms — the Republicans in the House and the Senate have made significant headway on both of these important proposals.

After passing their respective prescription drug packages late on the evening of June 26, lawmakers took a break for the Fourth of July holiday. They were planning to return July 7 to reconcile the two packages in conference before the end of July. Now is the perfect time to make that lobbying visit or phone call you've put off for so long.

And, if you have not written President Bush about the Medicare-reform issue, this is the time to do so, because the Administration will have a significant say in what is in the final Medicare package.

Why lobby now? Let's look at the facts:

In the Senate, the top Republican and Democratic lawmakers on the Senate Finance Committee announced in early June that they had reached agreement on a $400 billion Medicare prescription drug package. This package, called The Prescription Drug and Medicare Improvement Act (S.1) contains numerous Medicare provisions, including a seven-year consumer-price-index freeze for durable medical equipment reimbursement, a provision that all DME suppliers be accredited by 2006, and payment cuts to the average wholesale price reimbursement formula for Medicare-covered drugs.

The Senate Finance Committee approved the package June 17, and the package passed the full Senate by an overwhelming majority.

Meanwhile, in the House, the two health committees — Ways and Means, and Energy and Commerce — approved their own prescription drug and Medicare-reform packages. Each version of the Medicare Prescription Drug and Modernization Act of 2003 contained DME-related provisions, including a requirement that DME, and respiratory drugs used in conjunction with DME, be subject to competitive bidding.

By a slim vote, the House approved a reconciled version of these two bills.

Addressing Accreditation

While the industry should support the imposition of some real quality standards for Medicare DME providers, we only should do so with the assurance that accredited providers will receive some quid pro quo, such as reduced administrative costs (less paperwork, fewer DMERC audits, etc.). Why not require physicians to electronically prescribe — and complete certificates of medical necessity for — DME?