WASHINGTON — As expected, the Senate's health care reform bill contains a number of provisions that would directly affect HME.
Released this week, the $849-billion bill — called the Patient Protection and Affordable Care Act — will be up for its first test tomorrow night (Nov. 21) when the Senate is expected to vote on a motion to debate the measure. If 60 senators (a filibuster-proof majority) vote in its favor, the Senate would automatically adopt the motion. Floor debate would then likely begin after Congress' Thanksgiving recess.
A meld of the bills approved by the Senate Finance and Senate Health, Education, Labor and Pensions committees, many of the bill's HME provisions are "substantially similar" to those contained in the Finance Committee package released in September, according to Invacare's Cara Bachenheimer, senior vice president of government relations.
Bachenheimer said the bill would:
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Expand Round 2 of competitive bidding by 21 MSAs (from 79) for a total of 100 in the program. It would also require HHS to bid all areas of the country or apply bid rates nationwide by 2016.
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Impose an annual $2 billion fee on medical device manufacturers according to market share. Beginning in 2010, the fee would raise $20 billion over 10 years. (The excise tax proposal in the Finance Committee bill was double the size, calling for $40 billion over 10 years.)
The fee would not apply to sales of Class I or Class II products sold at retail for not more than $100. Small manufacturers with sales of $5 million or less would be exempt, and firms with U.S. sales between $5 million and $25 million would pay the tax on 50 percent of the sales.
According to Bachenheimer, a similar provision in the House health reform bill would also raise $20 billion over 10 years "but takes a wholly different approach to imposing the tax."
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Eliminate the first-month purchase option for standard power wheelchairs beginning in 2011. Payments would be front-loaded, with providers receiving 15 percent in months one through three and 6 percent in months four through 13. Group 3 and higher PWCs would be exempt.
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Eliminate the 2 percent add-on payment (above CPI) for DME in 2014 that Congress provided for in last year's Medicare Improvements for Patients and Providers Act. Instead, a "productivity adjustment" would reduce fee schedule updates by approximately 1 percent each year.
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Exempt pharmacies with less than 5 percent of revenues from Medicare DMEPOS from the accreditation requirement until HHS develops pharmacy-specific standards.
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The bill does not include any specific provisions relating to oxygen.
View the entire text of S. 3590 (all 2,074 pages of it).
