Washington Update, May 18, 2009
American Association for Homecare
- Senate Finance Lists Oxygen and Wheelchairs as Potential Cuts to Pay for Health Reform in 2009
- Fight for HME at AAHomecare's Washington Legislative Conference, June 1-3
- Calendar Update: June 18 Mobility Conference in Pittsburgh
Senate Finance Lists Oxygen and Wheelchairs as Potential Cuts to Pay for Health Reform
Today, the Senate Finance Committee released a list of revenue options for financing health care reform. The document targets Medicare home medical equipment payments for potential reduction in reimbursements but does not propose specific cuts to HME, although a press release issued by Senate Finance Chairman Max Baucus (D-Mont.) and Ranking Member Charles Grassley (R-Iowa) makes a specific reference to ensuring appropriate payments for "oxygen and power wheelchairs."
In Section I, titled "Health System Savings," the document discusses options for "ensuring appropriate payment," and one subsection is called, "More Appropriate Payment for Durable Medical Equipment," which describes the fee-schedule pricing mechanism used for DME in the Medicare program. The document outlines proposed options for revising DME payments:
"The Office of Inspector General (OIG) at the Department of Health and Human Services has identified potentially overvalued DME items and services; some contend reimbursement for certain DME items and services are under-reimbursed. The committee will explore options to improve payment accuracy for DME items and services."
The OIG has stated that Medicare overpays for a number of HME items. On April 22, 2009, 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. For example, in a 2006 report, OIG found that Medicare had allowed, on average, $7,215 for the rental of an oxygen concentrator that costs about $600 to purchase new. Additionally, beneficiaries incurred, on average, $1,443 in coinsurance charges. We determined that if home oxygen payments were limited to 13 months rather than the current 36 months, Medicare and its beneficiaries would save $3.2 billion over 5 years. In other work related to Medicare pricing, OIG currently is conducting work to examine the appropriateness of prices that Medicare pays for wheelchairs by comparing Medicare prices to suppliers' purchase prices.
OIG recently found that Medicare reimburses suppliers for negative pressure wound therapy pumps based on a purchase price of more than $17,000 but that suppliers paid an average of $3,600 for new models of these pumps. Negative pressure wound therapy pumps are a type of DME used to treat ulcers and other serious wounds. When Medicare first started covering wound pumps in 2001, it covered only one model, which was manufactured and supplied by one company. Medicare paid for this pump based on the purchase price as identified by that company. In 2005, Medicare expanded its coverage to include several new pump models manufactured by other companies. However, Medicare reimburses suppliers for these new pumps based on the original pump's purchase price, which is more than four times the average price paid by suppliers."
In their 2006 report, the OIG painted home oxygen as an overpaid item based on a study conducted that looked only at the cost of oxygen equipment. Earlier that same year, anticipating the OIG report, the American Association for Homecare commissioned Morrison Informatics to conduct a comprehensive study of the costs of providing home oxygen therapy. The resulting Morrison study found that equipment represents only 28 percent of the cost of providing medical oxygen in the homes of Medicare beneficiaries and the remaining 72 percent of costs represent delivery, compliance, patient education, 24-hour emergency service, and other non-equipment costs.
The American Association for Homecare asks HME providers to remind Congress that the home medical equipment sector has already suffered unwarranted and disproportionately large cuts in recent years. These payment reductions are threatening quality and access to home medical equipment and services.
"Further reductions to home medical equipment reimbursement will tear the already fragile safety net provided by homecare," said Tyler J. Wilson, president of the American Association for Homecare. "Home medical equipment and care helps reduce the length of expensive hospital and institutional care, allowing people to remain in the comfort of their own homes."
Fight for HME: Join Your Colleagues at AAHomecare's Washington Legislative Conference, June 1-3
Register today and join more than 200 of your colleagues in Washington, D.C., June 1-3 for the AAHomecare Washington Legislative Conference. This event is an important opportunity to tell your Senators and Representatives about the value of homecare and to make certain that the HME sector is part of the healthcare reform discussion. Among the speakers is Senator Arlen Specter (D-Penn.).
Talking points and other material will be provided to all registrants and the American Association for Homecare will schedule Capitol Hill appointments through our appointments concierge, sponsored by VGM. Please contact Gordon Barnes (gordonb@aahomecare.org or 703-535-1883) with any questions or special requests related to your Capitol Hill visits. For details of the fly-in or to register, please visit http://www.aahomecare.org/cde.cfm?event=236658.
Special thanks to our exhibitors and sponsors:
Aon Affinity Insurance Services, Inc.,
Brightree LLC
Brown & Fortunato,
Cailor Fleming Insurance,
Campania Management Company,
Capital Healthcare Group,
Domos HME Consulting Group
Fisher & Paykel Healthcare,
Invacare Corporation,
Medtrade,
Pacific Pulmonary Services,
Pacware Software Development,
Philips Respironics,
Pride Mobility Products,
QS/1 Data Systems,
ResMed,
Salter Labs,
Sunrise/DeVilbiss, and
Wright & Filippis.
Industry Supporters:
HME News,
HomeCare Monday,
Mobility Management, and
Respiratory Management.
For information on sponsoring or exhibiting at this event, please contact Kim Kianka at kimk@aahomecare.org.
Calendar Update
AAHomecare Mobility Conference, University of Pittsburgh, June 18
Changes in Medicare policy for power and manual mobility, seating and positioning, and repair services have catapulted providers into a state of confusion and at times, into financial loss. Participate in this presentation to better understand mobility, seating, and service policies and ways to maintain compliance while providing optimum qualifying products to beneficiaries. In the challenging healthcare environment before us, this program is imperative for all providers who continue to provide mobility, positioning, and repair services as well as for clinicians who evaluate and qualify patients for medically necessary durable medical equipment.
Speakers will include Dr. Paul Hughes, DME medical director for Jurisdiction A, Mark Schmeler, Ph.D., OTR/L, ATP from the Department of Rehabilitation Science & Technology at the University of Pittsburgh, and Georgie Blackburn, vice president of government relations for BLACKBURN's. The program is jointly sponsored by the American Association for Homecare, the University of Pittsburgh Medical Center, and the Department of Rehabilitation and Technology at the University of Pittsburgh. The event is supported by an education grant from Pride Mobility Products.
CEUs will be awarded to participants attending in person or by video conference and significant time will be allotted for interactive Q&A after each presentation and at the culmination of the program. Previous audio difficulties have been fixed. The program will take place on June 18 at the University of Pittsburgh. Contact Kim Kianka at kimk@aahomecare.org for more information.
WE THANK OUR CORPORATE SPONSORS
American Association for Homecare
2011 Crystal Drive, Suite 725
Arlington, VA 22202
For more information, please call AAHomecare at (703) 836-6263.
www.aahomecare.org
If you would prefer not to receive further messages from this sender, please
click on the following e-mail link and send a message with or without
any text:
Click here to opt out
You will receive one additional e-mail message confirming your removal.
Posts
