WASHINGTON--While most savings outlined in the Senate Finance Committee's colossal Medicare/Medicaid spending package for 2006 are aimed at reducing subsidies for the pharmaceutical industry, one section would hit the HME industry where it hurts, discontinuing the capped rental option for equipment.

According to AAHomecare, the provision would eliminate Medicare beneficiaries' choice to continue renting medical equipment in the capped rental category and would require transfer of title to patients for certain DME items after a 13-month rental.

On Monday, the association sent a letter opposing the change to Finance Committee Chairman Charles Grassley (R-Iowa) and Ranking Member Max Baucus (D-Mont.) making the following points:

--DME providers are currently required to notify patients about the option to rent or purchase durable medical equipment in the capped rental category, but the vast majority of Medicare beneficiaries prefer the rental option.

--It is neither safe nor fair to shift the burden of maintenance and repair for medical equipment to the disabled or elderly Medicare beneficiary.

--If the medical equipment is purchased, the patient incurs additional fees for clinical or emergency support or for exchange of malfunctioning equipment.

--There may be medical equipment items that should not be categorized as capped rental, but selecting those items should be carefully deliberated.

--Beneficiary access to power wheelchairs will be jeopardized by the provision.

An Oct. 21 letter to delivered to Grassley from VGM Management President Jim Walsh pointed out that "any elimination of 'maintenance fees' (after the capped rental period ends) will likely result in seniors having difficulty with the equipment or having to pay for repairs and maintenance themselves ... Half of the compromise that created the 'capped rental' concept was that the maintenance fee replaced continued rental payments. Maintenance doesn't go away with the wave of the legislative wand ... it just means people who already have serious health problems have to pay for things themselves or live with poorly or non-functioning equipment."

The full Senate is expected to vote on its plan, including the capped rental measure, this week.