WASHINGTON--Inconsistencies in the language of the House and Senate versions of the Deficit Reduction Act (S. 1932) that President Bush signed into law Wednesday could possibly give industry stakeholders a second chance at defeating the legislation.

The bill Bush signed varied slightly from the final version passed by the House, Reuters reported Thursday: Since December, as the bill was passed back and forth between the two chambers, a typo was written into it through a clerical error.

The House and Senate passed legislation as a fix to the error after the president had already signed the bill, but on Friday Democratic leaders in the House were reportedly still insisting on a re-vote for the original measure.

According to Reuters, the error was related to Medicare payments for medical equipment rentals. A spokesperson for the American Association for Homecare described the error as "a typo in [the] House version of S. 1932 that capped HME items at 36 months instead of 13."

As the drama of the error unfolded Thursday, industry stakeholders found themselves in a fog of hope and uncertainty, with erroneous and confusing press accounts circulating about the inconsistencies.

Ultimately, though, the spokesperson added, "It's possible that there could be one last-ditch effort to vote again on the capped rental provision, although it's a long shot."

Meanwhile, the industry is already feeling the effects of the DRA, the provisions of which are effective Jan. 1, 2006. Late Friday, CMS released a fact sheet outlining the changes the law brought about, including the following:

--The DRA makes some changes to Medicare payments for rental arrangements for durable medical equipment. Prior to the DRA, "capped rental" items are rented by Medicare for up to 15 months; after 15 months, the supplier continues to furnish the equipment to the beneficiary as long as the beneficiary needs it, but the supplier retains title to the equipment.

Beginning with items newly rented on or after Jan. 1, 2006, the DRA changes the rental period to 13 months. After the end of the rental period, title to the equipment transfers to the beneficiary. Medicare will continue to pay for reasonable and necessary service and maintenance after the end of the rental period. CMS will issue instructions to its contractors to implement these changes later this year.

--The DRA also makes some changes to Medicare payments for oxygen equipment. Prior to the DRA, oxygen equipment was rented indefinitely. The bill caps the rental period at 36 months, after which time the beneficiary will own the equipment. After the beneficiary owns the equipment, the DRA requires Medicare to pay for reasonable and necessary service and maintenance. The DRA also requires Medicare to continue to pay for gaseous and liquid oxygen contents for beneficiaries using stationary or portable oxygen tanks and cylinders after the beneficiary using that equipment owns it.

The DRA provides for a new 36-month rental cap period beginning Jan. 1, 2006, for all oxygen equipment. Thus, a new 36-month rental cap period would apply both for beneficiaries starting to use the equipment as well as for beneficiaries who have been using it for several years. CMS will issue instructions to its contractors to implement these changes later this year.

--The DRA changes from 27 to 29 the minimum number of days after the receipt of a non-electronic (paper) claim before Medicare will pay the claim. Medicare's carriers and intermediaries will implement this extended period as soon as possible.

--Caps on payments for outpatient therapy services went into effect Jan. 1. Two separate caps are in place: $1,740 per beneficiary per year for physical therapy and speech-language pathology, and the same amount for occupational therapy.

The new law also requires a one-time hold on Medicare payments for the period of Sept. 22 through Sept. 30, 2006. According to CMS, "payment on claims that would have otherwise been paid on one of these nine days will be made on the first business day of October 2006."