WASHINGTON--In his $2.77 trillion FY 2007 budget proposal, released last week, President Bush calls for a major bump in spending to develop a nationwide, interoperable health information network, including personal electronic health records for most Americans by 2014. He proposes $169 million in health information technology spending for the Department of Health and Human Services, up from $111 million in the current year.

The president's budget request from Congress also asks for $6 million for a Food and Drug Administration initiative called "Critical Path to Personalized Medicine," which would focus on cutting-edge research methods and better designed clinical trials.

But the budget also calls for some $36 billion in reductions to Medicare and more than $1.5 billion to Medicaid over five years. Additional proposed regulatory changes would reduce federal funding for Medicaid by another $12.3 billion over the same timeframe.

A response from AAHomecare said the association is opposed to several provisions in the budget specifically targeting home health care, including a proposal to transfer ownership of medical oxygen equipment to Medicare beneficiaries after 13 months, a freeze on home health reimbursement and elimination of the ability to purchase power wheelchairs in the first month.

"Continuing cuts to home care erode the cost-effective infrastructure of home care that will be essential to the nation's health care needs, especially as baby boomers near Medicare eligibility," said Tom Ryan, AAHomecare chairman and CEO of Homecare Concepts in Farmingdale, N.Y., in a statement issued Wednesday.

"The expected growth in number of Medicare beneficiaries and increasing length of time they will need health care services should encourage policymakers to keep cost-effective care methods such as home care in mind as they create budget policy," he continued.

According to the association, the proposed budget's limit of 13 months on the oxygen rental period would exacerbate the recent 36-month cap on medical oxygen that was included in the Deficit Reduction Act (S. 1932), which Bush signed into law on Wednesday. (See story in this issue.)

The forced transfer of ownership of oxygen equipment places unfair burdens and uncertainty on beneficiaries, AAHomecare said, and the freeze on home health reimbursement is "unwarranted and unwise, given rising costs for home health agencies and the widely recognized value that home health care delivers to the Medicare and Medicaid programs."

Seth Johnson, chair of AAHomecare's Rehab and Assistive Technology Council and director of government affairs for Pride Mobility, said the proposal to eliminate first-month purchase of power wheelchairs is worrisome because they are provided to beneficiaries with disabilities that are long-term conditions, and more than 95 percent of power wheelchairs are purchased in the first month.

"The RATC will work closely with Congress as they begin to develop Medicare legislation this year," Johnson said. "The council is very concerned about the impact an elimination of the first-month purchase option would have on beneficiaries and suppliers and will work to educate Congress on the many reasons why this is bad policy."

Because it is up to Congress to decide whether to pass legislation containing any provisions from the president's budget proposal, AAHomecare said, "it will be important for the home care community to be vocal about its opposition to these proposed changes."