In these pages, home care advocates have already spilled plenty of ink about why the 36-month cap on oxygen in the Deficit Reduction Act of 2005 is bad medicine. Changing oxygen from a continuous rental to a rent-to-purchase item ignores the importance of the ongoing patient-provider relationship.
And the DRA change treats the oxygen benefit as merely a piece of medical equipment rather than understanding it as a therapy that requires numerous provider services and costs beyond the equipment itself. (Specifics about those services and their costs will be detailed in a study by the American Association for Homecare that is currently under way.)
But there's more.
As one Washington insider has observed, this new policy is like a dial. Now that oxygen therapy is considered a capped-rental item, some congressional lawmakers see an easy opportunity to dial the rental period down to an 18-month cap. Or 13 months.
Remember that the president's proposed 2007 budget includes a provision to dial the oxygen cap down to 13 months. This is a real threat. After the November election, budget-cutters will be tempted to sneak the 13-month provision into a moving bill. And if not this year, then it will be on the table next year.
So, we need to remind members of Congress that this new oxygen policy poses risks: A million oxygen patients may be finding it harder to breathe.
That's why home care advocates are lining up behind a bill that would repeal the oxygen provisions in the DRA. Michigan congressman and physician Joe Schwarz, who is a Republican from the 7th district, has introduced The Home Oxygen Patient Protection Act, which would repeal the provision and return oxygen to policy in place before the DRA became law.
Congressman Schwarz has lined up several original co-sponsors, including fellow physician and Congressman Tom Price, R-Ga. A groundswell of support for this bill in the way of co-sponsors would demonstrate the broad opposition to the DRA oxygen provision, which was so evident during the debate over the bill that took place during December and January.
The home care community has already demonstrated that it has tremendous grassroots power. Now is the time to use it.
What can be done? Urge your members of Congress to cosponsor the Schwarz bill. Attend the AAHomecare Washington Fly-In June 19-20. On June 20, the fly-in will include a Home Oxygen Patient and Technology Fair on Capitol Hill designed to bring members of Congress together with home oxygen patients, providers and manufacturers to learn about the issues in an informal setting.
If you can't participate in person, then call in, and urge your patients to do so as well. On June 20, providers will be encouraging home oxygen patients and their families to call their senators and representatives in support of the Schwarz bill and repeal of the DRA provisions. For specific message points, see the advocacy updates, Grassroots Toolbox and congressional look-up buttons at www.aahomecare.org. Or, call the U.S. Capitol switchboard at 202/224-3121 and ask for your congressional representative. Phone calls and meetings with constituents do make a difference.
Earlier this year, AAHomecare created a very simple chart titled “Homecare Is Not the Problem in Medicare.” Using 2006 CMS National Health Expenditure data, the chart shows that total Medicare spending grew from $148.4 billion in 1993 to $335.5 billion in 2005. Over the same period, home medical equipment spending in Medicare grew from $2.7 billion to $6.5 billion.
The chart shows that HME spending has been virtually flat over the last three years, while total Medicare spending continued to skyrocket up another $50 billion. In other words, home care is not the problem in Medicare; it's part of the solution to Medicare's woes.
It's important to provide that context to members of Congress and the administration so they understand that home care is cost-effective as well as clinically effective — and preferred by their constituents.
Michael Reinemer is vice president for communications and policy at the American Association for Homecare, Alexandria, Va. For more information about AAHomecare, call 703/836-6263 or visit www.aahomecare.org.
