Washington
At press time, the Alexandria, Va.-based American Association for Homecare reported that conferees appeared to be considering a mix of measures affecting the home medical equipment industry proposed in both the House of Representatives and Senate versions of the Medicare reform bill. The combination would include a CPI freeze on DME, followed by competitive bidding on selected products to be determined by the Department of Health and Human Services.
Initially, according to the proposal, competitive bidding would take place in metropolitan areas greater than one million. Starting in fiscal year 2007, though, the HHS Secretary could decide to move competitive bidding nationwide and to include a wider range of products, the association said.
However, AAHomecare and others emphasized such considerations are by no means final and that negotiations on DME issues remained fluid. “There are many rumors, and it's very difficult to confirm what is real and what isn't,” said Cara Bachenheimer, vice president, government relations, Invacare, Elyria, Ohio. “Nothing is definitive now.”
What's more, once agreements are finalized on any of the reform bill's measures, including a prescription drug benefit, the draft must go through Congressional Budget Office scoring. Earlier this year, lawmakers vowed to keep any final Medicare bill less than $400 billion.
While conferees missed a self-imposed Oct. 17 deadline for completing their report and had pushed that date to Oct. 31, President Bush urged Congress to continue working to deliver a prescription drug benefit under the Medicare program. According to Washington insiders, the bill could hit a roadblock in the Senate, where Minority Leader Tom Daschle, D-S.D., and 40 other senators signed a letter opposing the prescription drug benefit proposed in the House version of the bill.
Another issue that some believe could be a deal-breaker is whether to allow Medicare to compete with private plans, as proposed in the House bill. Advocates say such a plan will drive down costs, while critics say the proposal will cause healthier seniors to choose private plans. The result could be higher premiums for seniors in fee-for-service Medicare.
Even as Medicare reform edges toward the brink, talk is already emerging about the next big health care issue on the Hill. According to Democrat and Republican congressional staffers, debate on Medicaid reform likely will launch next year.
For updates, check HomeCare Monday at www.homecaremonday.com.
For breaking news, go to www.homecaremonday.com, the electronic news service of the home medical equipment industry.
