Washington
With the House of Representatives scheduled for a final vote on the 2006 federal budget reconciliation bill in early February, at press time HME stakeholders were scrambling to pick up last-minute “no” votes against the measure.
S. 1932 contains $39.7 billion in spending reductions, with $6.4 billion in savings from Medicare and $4.8 billion from Medicaid. The bill also includes a provision that would cap oxygen rentals at 36 months and rentals of most other DME (excluding power wheelchairs) at 13 months. At that time, title to the equipment would transfer to the beneficiary, shifting responsibilities for servicing and maintaining the equipment from providers to users.
Opposition to the provision, unexpectedly inserted by House Ways and Means Committee Chairman Bill Thomas, R-Calif., has been strong from providers and other home health advocates.
“It's such a scary provision because when ownership transfers, the provider doesn't have an ongoing responsibility. [Oxygen equipment] is a life-sustaining prescription device, and this provision leaves the beneficiary without a lifeline,” according to Cara Bachenheimer, vice president of government relations for Elyria, Ohio-based Invacare Corp.
For example, in the event of an emergency such as a power failure or hurricane, providers would routinely have extra tanks delivered, she said. But under the pending provision, she asked, “How are [beneficiaries] going to obtain those services if Medicare is not going to pay for it?”
The subject was even raised on Jerry Springer's radio show Jan. 5 during a discussion of federal budget cuts. Josh Sorrell, a Cynthiana, Ky.-based provider who called in to the show, said that Springer brought up the proposed oxygen cuts as an example.
“I made a point [that the government will be] shifting the burden to patients,” said Sorrell, owner of Sorrell Home Medical. “By not having us maintain equipment, they're probably going to incur more costs rather than save money.” Without the help of providers, he added, many of these patients “would probably end up in the emergency room.”
According to the American Association for Homecare, the bill provides no guidance for service components such as disposable accessories, emergency service or equipment replacement that are currently required under Medicare oxygen rules.
Once the patient owns the items, the beneficiary will become responsible for delivery and filling, the association said. “There are numerous state and federal regulations governing the safe handling, filling and transport of medical oxygen that will be complicated with this change in ownership.”
