Can the Good Guys Win?
Despite those official rejoinders, the question remains: In light of the tidal wave of negative press, can the industry shore up its reputation?

Most stakeholders believe that will take all home care providers stepping up to the plate to ensure the accurate story of HME gets out to their legislators. While Washington insiders agree it is unlikely federal lawmakers will reach agreement on Medicare this year--"We are running out of time in terms of a Christmas deadline," said Bachenheimer--no one is suggesting waiting to lobby until Congress returns next year.

"The threat is really real," said Seth Johnson, vice president of government relations for Pride Mobility Products, Exeter, Pa.

As of Friday, the House Medicare package called for cutting home oxygen rental payments from 36 to 18 months. While the Senate package was not set, "we do know the Senate has a $77 reduction [for oxygen] in their package, which would take it down to around $120 a month," Johnson said. "As far as the first-month purchase option for power wheelchairs, we have heard conflicting information about whether it's in the Senate bill or not. Regardless, going into negotiations, it's clearly on the table for inclusion.

"What we need the industry to do is to pick up the phone and call their legislators and let them know what the impact of these two provisions in the Medicare package would be and what the impact would be on their companies if these changes are implemented," Johnson said.

Bachenheimer, too, stressed the need for provider lobbying. "People get frustrated or dismayed that they can't get a meeting [with their legislators], but they just have got to keep at it," she said.

Despite the bad news, Bachenheimer continued, "the industry has done a decent job [of lobbying] this year relative to previous years. There are a lot of folks who advocate for us."

She lauded in particular the support of Sen. Pat Roberts, R-Kan., a member of the powerful Senate Finance Committee, which oversees Medicare. "He's a huge advocate," Bachenheimer said. "He's really close to his constituents. Over the years, providers have been educating him, and he sees access to home medical products and services as critical ... It's wonderful to see some of the results of these efforts over the years."

Hoping for a Fair Shake
Raul Lopez, president of the Florida Association of Medical Equipment Services and director of operations for Bayshore Dura Medical in Miami Lakes, is hoping that education about HME will make the difference in NBC's upcoming report.

Lopez spent three hours with NBC News correspondent Mark Potter three weeks ago. The reporter, who was following the NPR story on fraud and abuse in Miami, had already spoken to Health and Human Services Secretary Michael Leavitt and gone on a ride-along with the FBI to a non-existent HME facility.

Lopez took him on a tour of Bayshore's 20,000-sq. ft. facility, explained the industry and even armed Potter with a General Accounting Office report on Medicare "that showed $70 million to $75 million of Medicare's own boo-boos."

He has no idea how much, if any, of his 25 minutes on tape Potter will use. But he is hopeful the NBC story will, at the least, present a balanced view of the industry. "Though the focus of the story is fraud, the fact that Mr. Potter went out of his way to look at our perspective and acknowledge that there are good providers out there serving beneficiaries was a great opportunity to change some minds," Lopez said in a FAMES memo about the reporter's visit.

"[Potter] was open-minded enough to look for legitimacy in the industry," Lopez told HomeCare Monday. "I was quite pleased with that. Even if it is a 10-second blurb, it's better than we've ever gotten before."

Said VGM's Walsh, "It's a continuing public relations battle, and it's always going to have to be fought. This is not a day-to-day battle, this is a decade-to-decade battle. We re going to have to make a convincing case that home care can effectively cut health care costs for everyone.

"I guess," he said, "it's shame on us for not being able to effectively get that message across."

For more information:
Read field notes on his report from NBC News correspondent Mark Potter.

View Charles Duhigg's New York Times article.

View AAHomecare's response to the New York Times article.

View a response to the New York Times article from the CQRC.

View the OIG report on Medicare power wheelchair pricing.