AAHomecare to Senate Finance: Take HME Off List of Potential Cuts

Committee has been considering HME cuts to pay for health reform.

  • May 28, 2009

The American Association for Homecare sent a letter to theSenate Finance Committee (at the committee’s request) outlining concerns about its list of options for financing health reform through Medicare cuts.

The Senate Finance list targets Medicare payments for home medical equipment for potential reimbursement reductions but does not propose specific cuts to HME.  Section I of the document, “Health System Savings,” discusses options for “ensuring appropriate payment,” and one subsection, “More Appropriate Payment for Durable Medical Equipment,” cites the Office of Inspector General at the HHS as saying that fees for certain DME items are overpriced.

On April 22, Inspector General Lewis Morris told the Senate Homeland Security subcommittee on Federal Financial Management that “Prior OIG work also has found that Medicare pays too much for certain pieces of DMEPOS and related supplies, such as power wheelchairs, hospital beds, diabetic supplies, and home oxygen equipment.”

In this week’s six-page letter, AAHomecare reiterated that the HME sector has been subjected to a long series of deep and disproportionate reductions in Medicare reimbursements in recent years. It said those cuts are having a negative impact on the quality of care that Medicare beneficiaries and physicians alike have come to expect.  

The letter, sent to committee Chairman Max Baucus (D-Mont.)and Ranking Member Charles Grassley (R-Iowa), recommended the following actions:

• Refrain from further cuts to oxygen and enact budget-neutral reform to improve quality of care and increase cost transparency.


• End the “competitive” bidding program, which is a flawed administrative pricing mechanism that produces arbitrary and capricious pricing that will reduce access to care and put thousands of small providers out of business.

• Restore appropriate payment for complex rehab to preserve beneficiary independence.

• Enact effective and aggressive fraud and abuse measures that focus on preventing and detecting Medicare fraud early, which is a more proactive approach than the current “pay and chase” system of combating fraud.


Comments

Fri, Jun 12, 2009 Michael Reinemer Washington, DC

Responding to W.P. Reed's comment, the AAHomecare letter to Senate Finance DOES address the oxygen cap in three separate places on pages two and three, calling explicitly for the repeal of the cap and expressing support for the HOPP Act. If you want to find out what the American Association for Homecare is doing and where it stands, you'll have to dig deeper than reading short articles in the trade publications. For details, visit www.aahomecare.org. Or specifically, www.aahomecare.org/oxygen.

Fri, Jun 5, 2009 MESHELLE lake charles ,la

DOSSE MEDICARE NOT UNDER STAND THAT IN RUAL AREAS WE TRAVEL AS FAR AS 100 MILES TO PROVIDE OUR SERVICES THAT THEY SET UP GUIDELINES FOR.ALSO APPLES TO APPLES IF ONE OF OUR PATIENTS GOSE INTO THE HOSPITAL FOR A COPD EPISODE OXYGEN FOR 30 DAYS IS ABOUT 1000.00 A DAY VERSES AT HOME FOR 179.00, WHICH STILL DOSENT COVER YOUR NURSE OR R.T. OR YOUR DRIVER OR YOUR VAN AND GAS AND INSURANCE FOR ALL OF THIS SO WHOS DOING THE REFORM, BECAUSE SOMEONE DOSEN'T HAVE GOOD SOURCES.IAM A SMALL BUSINESS OWNER THAT ALL THESE CUTS HAVE ALMOST DRIVEN ME OUT OF BUSINESS, AND ITS A SHAME BECAUSE I HAVE BEEN IN BUSINESS FOR 11 YRS. MY PATIENTS ARE GETTING THE A REAL BAD DEAL, BECAUSE THEY ARE POOR PEOPLE, NOT PEOPLE WHO HAAVE 2 OR 30 MILLION DOLLAR BOUNS AND FULL PAY RETIREMENT ATFER SERVING 1 TERM ON OFFICE OR A CEO OF A BIG CORPATION. WOULD SOME PLEASE HELP US SMALLER PEOPLE PLEASE BEFORE ITS TO LATE. THANKS MESHELLE

Fri, May 29, 2009

Just today my company ran into a situation regarding portable oxygen. We recieved a denial for services. How in the world does Medicare expect companies to supply oxygen contents and not collect on these services. We as home care providers have to pay for refill of contents and then we pass this on as a free service. Also, they quality of care for seniors is rapidly detoritating due to cap on oxygen. These patients are unable to maintain their equipment on a daily basis and we are expected to service without compensation with the price of fuel. My company has always maintained good quality care by routinely visiting our patients on a by monthly basis, which by the way is necessary for elderly seniors. The rules for updating equipment per patient request is vague and extremely confusing, that Medicare customer service reps are unable to answer question properly. I had on employee to put me on hold approx 5 times during on conversation to ask another employee for answer. Only to contact one of our patients and told them that they did infact owned the oxygen equipment when in fact the new rules states that the supplier retains ownership. If they don't understand the rules, how do we as suppliers understand them. Very Poor quality care is on the rise. Oxygen is a prescribed drug and must be maintained for proper use.

Fri, May 29, 2009 w. p. reed ft. myers, fl

I'm surprised and disappointed that AAHomecare's letter did not address the 36 month cap for home oxygen. Of all the changes enacted by Medicare this one makes the least sense, will probably result in some providers exiting the business and without question puts the patient's health at risk.

Fri, May 29, 2009 GAIL MEYER LONG ISLAND, NY

IN RURAL AREAS AS WE ARE, INSURANCE COMPANIES ARE FORCING OUR CUSTOMERS TO TRAVEL LONG DISTANCES TO FIND A PARTICIPATING PROVIDER. THE COMPETITIVE BIDDING PROGRAM IS NOT CONDUCIVE TO EXCELLENT SERVICE AND WILL POSE A PROBLEM, ESPECIALLY OXYGEN PATIENTS. ISN'T THE GOVERNMENT AWARE OF THE HORRIFIC TRAFFIC CONGESTION ON LONG ISLAND? THANK YOU.

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