Offense and Defense

Regardless of how it deals with the SCHIP reauthorization issue in September and beyond, Congress will continue this year to pursue a Medicare bill, driven primarily by the desire to fix the Medicare physician fee schedule so that doctors don't receive a payment cut in 2008. The unresolved question is whether this will turn into a major Medicare bill, with opportunities and vulnerabilities for our industry, or whether Congress will only pass legislation affecting physicians.

If a larger bill is addressed, we have opportunities like the Tanner-Hobson and Conrad-Hatch competitive bidding bills and repeal of the oxygen equipment ownership mandate. At the same time, there are vulnerabilities if Congress needs to find ways to pay for items. Therefore, we must take both the offensive and the defensive. If you haven't yet communicated these priorities to your senators and representatives, do it today.

• Congress must pass the Tanner-Hobson and Conrad-Hatch competitive bidding bills

  While we currently have 110 members in the House signed on, we need more! Contact your representatives and senators and ask them to sign on to H.R. 1845/S. 1428 as a co-sponsor. Congress should pass these bills because they will better ensure beneficiary access to quality HME services under competitive acquisition and will rationalize CMS' implementation of the program.

  The bills will allow “any willing provider” to participate (the Senate bill would limit that provision to providers with $6 million or less in annual revenues). The House bill will also require Congress to re-authorize the program before CMS can expand it beyond the original 10 metropolitan statistical areas.

  The bills aim to ensure competition is maintained in the marketplace. Approximately 90 percent of DME suppliers are small businesses, and the bills will facilitate small business participation in the program.

• Congress must reject cuts to the Medicare home oxygen benefit. The Medicare home oxygen benefit has been cut significantly over the past few years, and a majority of these cuts have yet to be realized.

  Congress and CMS have enacted, or are in the process of implementing, significant policy changes to the benefit that will result in cuts of 19 percent in the next two years. These cuts include the industry-wide competitive bidding program and a Medicare payment cap for home oxygen after 36 months.